Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.90 / $79.73 / $192.85	Facility		$32.90	$79.73	$192.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.85 / $32.90 / $52.50	Professional		$28.85	$32.90	$52.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $36.75 / $56.00 / $144.60	Facility		$36.75	$56.00	$144.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $31.50 / $72.51 / $262.50	Professional		$31.50	$72.51	$262.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.40 / $74.40 / $102.38	Facility		$36.40	$74.40	$102.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.52 / $39.29 / $47.80	Professional		$18.52	$39.29	$47.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $34.40 / $43.75 / $99.53	Facility		$34.40	$43.75	$99.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $51.45 / $97.02	Professional		$35.00	$51.45	$97.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.15 / $34.26 / $75.00	Professional		$31.15	$34.26	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $35.00 / $73.50	Facility		$35.00	$35.00	$73.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.75 / $61.25 / $105.00	Facility		$31.75	$61.25	$105.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.50 / $43.75 / $52.85	Professional		$31.50	$43.75	$52.85
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $36.75 / $57.44 / $96.25	Facility		$36.75	$57.44	$96.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $38.71 / $68.02 / $81.27	Professional		$38.71	$68.02	$81.27
United Facility/Professional Professional Modifier Low / Median / High Price $14.70 / $14.70 / $39.20	Professional		$14.70	$14.70	$39.20