Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.46 / $75.95 / $79.30	Facility		$33.46	$75.95	$79.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.09 / $33.46 / $75.95	Professional		$19.09	$33.46	$75.95
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $51.71 / $112.46 / $288.52	Facility		$51.71	$112.46	$288.52
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $49.02 / $51.71 / $432.53	Professional		$49.02	$51.71	$432.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.50 / $25.43 / $25.43	Professional		$21.50	$25.43	$25.43
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $50.92 / $84.36 / $122.79	Facility		$50.92	$84.36	$122.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.92 / $84.36 / $122.79	Professional		$50.92	$84.36	$122.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $49.79 / $49.79	Professional		$40.74	$49.79	$49.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $49.48 / $60.86 / $68.16	Facility		$49.48	$60.86	$68.16
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $50.19 / $62.32 / $62.32	Professional		$50.19	$62.32	$62.32
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.02 / $51.71 / $95.62	Facility		$49.02	$51.71	$95.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.02 / $57.67 / $66.31	Professional		$49.02	$57.67	$66.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $47.68 / $50.19 / $59.05	Professional		$47.68	$50.19	$59.05
United Facility/Professional Professional Modifier Low / Median / High Price $24.88 / $31.78 / $50.42	Professional		$24.88	$31.78	$50.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.11 / $28.11 / $50.19	Professional		$28.11	$28.11	$50.19