Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.79 / $60.64 / $99.09	Facility		$30.79	$60.64	$99.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.08 / $36.70 / $73.81	Professional		$25.08	$36.70	$73.81
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $37.21 / $37.21 / $51.58	Professional	25	$37.21	$37.21	$51.58
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $63.42 / $64.43 / $154.38	Facility		$63.42	$64.43	$154.38
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $46.76 / $78.37 / $222.87	Professional		$46.76	$78.37	$222.87
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $31.16 / $43.38 / $69.98	Professional	25	$31.16	$43.38	$69.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.46 / $65.19 / $111.04	Professional		$34.46	$65.19	$111.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $25.03 / $39.24 / $72.27	Facility		$25.03	$39.24	$72.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.03 / $39.24 / $70.20	Professional		$25.03	$39.24	$70.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.57 / $96.15 / $159.02	Professional		$18.57	$96.15	$159.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $48.84 / $79.80 / $96.48	Facility		$48.84	$79.80	$96.48
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.42 / $63.42 / $63.42	Facility		$62.42	$63.42	$63.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.68 / $81.13 / $111.46	Professional		$49.68	$81.13	$111.46
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $48.09 / $64.42 / $99.65	Professional		$48.09	$64.42	$99.65
United Facility/Professional Professional Modifier Low / Median / High Price $48.40 / $64.90 / $127.63	Professional		$48.40	$64.90	$127.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.26 / $39.20 / $51.55	Professional		$33.26	$39.20	$51.55