Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.17 / $57.14 / $59.65	Facility		$25.17	$57.14	$59.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.46 / $25.17 / $61.33	Professional		$19.46	$25.17	$61.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $39.57 / $86.29 / $211.82	Facility		$39.57	$86.29	$211.82
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $29.71 / $39.61 / $225.39	Professional		$29.71	$39.61	$225.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.14 / $29.14 / $29.14	Facility		$29.14	$29.14	$29.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.27 / $21.27 / $33.58	Professional		$21.27	$21.27	$33.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $24.59 / $43.21 / $79.58	Facility		$24.59	$43.21	$79.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.92 / $45.26 / $85.56	Professional		$25.92	$45.26	$85.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.02 / $33.36 / $36.69	Professional		$30.02	$33.36	$36.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $34.63 / $44.25 / $45.26	Facility		$34.63	$44.25	$45.26
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $38.03 / $45.26 / $45.26	Professional		$38.03	$45.26	$45.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $37.61 / $39.57 / $86.29	Facility		$37.61	$39.57	$86.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.61 / $42.92 / $65.02	Professional		$37.61	$42.92	$65.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $43.06 / $44.25 / $44.25	Facility		$43.06	$44.25	$44.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $29.38 / $38.47 / $49.79	Professional		$29.38	$38.47	$49.79
United Facility/Professional Professional Modifier Low / Median / High Price $19.19 / $22.39 / $38.75	Professional		$19.19	$22.39	$38.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.79 / $28.79 / $28.79	Professional		$28.79	$28.79	$28.79