Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.99 / $37.99 / $163.22	Facility		$37.99	$37.99	$163.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.21 / $25.01 / $37.99	Professional		$19.21	$25.01	$37.99
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $111.58 / $450.61 / $925.91	Facility		$111.58	$450.61	$925.91
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $28.58 / $77.88 / $273.60	Professional		$28.58	$77.88	$273.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $0.98 / $2.15 / $50.76	Facility		$0.98	$2.15	$50.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.62 / $27.32 / $41.99	Professional		$11.62	$27.32	$41.99
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $20.82 / $40.74 / $95.72	Facility		$20.82	$40.74	$95.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $21.01 / $40.74 / $80.26	Professional		$21.01	$40.74	$80.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $44.00 / $75.00	Professional		$40.00	$44.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $39.04 / $46.90 / $186.41	Facility		$39.04	$46.90	$186.41
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $39.04 / $39.04 / $39.04	Professional		$39.04	$39.04	$39.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.78 / $30.78 / $30.78	Professional		$30.78	$30.78	$30.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $289.37 / $473.30 / $920.49	Facility		$289.37	$473.30	$920.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $43.89 / $61.51 / $80.75	Professional		$43.89	$61.51	$80.75
United Facility/Professional Professional Modifier Low / Median / High Price $8.64 / $14.25 / $33.92	Professional		$8.64	$14.25	$33.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $11.19 / $11.19 / $13.82	Professional		$11.19	$11.19	$13.82