Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.43 / $75.89 / $79.23	Facility		$33.43	$75.89	$79.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.28 / $33.43 / $61.15	Professional		$28.28	$33.43	$61.15
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $98.32 / $270.82	Facility		$40.00	$98.32	$270.82
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $282.11 / $445.35	Professional		$50.00	$282.11	$445.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.86 / $30.86 / $30.86	Professional		$30.86	$30.86	$30.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $35.88 / $75.09 / $118.36	Facility		$35.88	$75.09	$118.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.96 / $75.09 / $118.36	Professional		$35.96	$75.09	$118.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $60.00 / $60.45	Professional		$30.00	$60.00	$60.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $47.99 / $93.08 / $102.51	Facility		$47.99	$93.08	$102.51
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $47.99 / $47.99 / $47.99	Professional		$47.99	$47.99	$47.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $40.00 / $40.00	Facility		$40.00	$40.00	$40.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $40.00 / $59.03	Professional		$40.00	$40.00	$59.03
United Facility/Professional Professional Modifier Low / Median / High Price $25.63 / $36.78 / $48.90	Professional		$25.63	$36.78	$48.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.72 / $42.72 / $46.32	Professional		$42.72	$42.72	$46.32