Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.56 / $49.86 / $88.02	Facility		$22.56	$49.86	$88.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.97 / $28.61 / $49.86	Professional		$15.97	$28.61	$49.86
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $134.74 / $185.40 / $371.44	Facility		$134.74	$185.40	$371.44
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $24.09 / $52.21 / $251.37	Professional		$24.09	$52.21	$251.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.10 / $42.82 / $103.62	Professional		$21.10	$42.82	$103.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $16.13 / $35.57 / $83.82	Facility		$16.13	$35.57	$83.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $15.95 / $32.54 / $66.89	Professional		$15.95	$32.54	$66.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.59 / $52.32 / $93.99	Professional		$9.59	$52.32	$93.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $38.76 / $64.34 / $78.39	Facility		$38.76	$64.34	$78.39
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.19 / $51.19 / $53.47	Facility		$51.19	$51.19	$53.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.59 / $53.02 / $95.64	Professional		$28.59	$53.02	$95.64
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $136.19 / $186.95 / $371.44	Facility		$136.19	$186.95	$371.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $24.02 / $48.91 / $88.08	Professional		$24.02	$48.91	$88.08
United Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $62.62 / $111.03	Professional		$38.00	$62.62	$111.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $17.13 / $32.85 / $44.65	Professional		$17.13	$32.85	$44.65