Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.69 / $74.20 / $77.48	Facility		$32.69	$74.20	$77.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.14 / $32.69 / $77.48	Professional		$20.14	$32.69	$77.48
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $50.53 / $99.37 / $275.37	Facility		$50.53	$99.37	$275.37
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $47.91 / $50.53 / $422.70	Professional		$47.91	$50.53	$422.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.73 / $31.73 / $31.73	Professional		$31.73	$31.73	$31.73
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $43.18 / $83.65 / $121.05	Facility		$43.18	$83.65	$121.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.50 / $83.65 / $122.79	Professional		$50.50	$83.65	$122.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.72 / $56.36 / $78.90	Professional		$50.72	$56.36	$78.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $56.36 / $57.71 / $68.84	Facility		$56.36	$57.71	$68.84
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $50.41 / $50.41 / $50.41	Professional		$50.41	$50.41	$50.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.91 / $50.53 / $93.44	Facility		$47.91	$50.53	$93.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.91 / $56.36 / $64.81	Professional		$47.91	$56.36	$64.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $46.60 / $49.05 / $57.71	Professional		$46.60	$49.05	$57.71
United Facility/Professional Professional Modifier Low / Median / High Price $25.18 / $31.19 / $50.28	Professional		$25.18	$31.19	$50.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $49.05 / $49.05 / $66.00	Professional		$49.05	$49.05	$66.00