Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.31 / $57.63 / $78.94	Facility		$33.31	$57.63	$78.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.53 / $32.53 / $57.63	Professional		$32.53	$32.53	$57.63
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $37.22 / $66.89 / $216.18	Facility		$37.22	$66.89	$216.18
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $37.22 / $37.22 / $354.51	Professional		$37.22	$37.22	$354.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.31 / $33.31 / $66.62	Facility		$33.31	$33.31	$66.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.31 / $33.31 / $33.31	Professional		$33.31	$33.31	$33.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $33.17 / $82.76 / $415.53	Facility		$33.17	$82.76	$415.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.17 / $84.31 / $420.21	Professional		$33.17	$84.31	$420.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.95 / $40.95 / $75.00	Professional		$40.95	$40.95	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $37.22 / $37.22 / $37.22	Facility		$37.22	$37.22	$37.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.22 / $37.22 / $37.22	Professional		$37.22	$37.22	$37.22
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $37.22 / $37.22 / $37.22	Facility		$37.22	$37.22	$37.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $35.36 / $37.22 / $37.22	Professional		$35.36	$37.22	$37.22
United Facility/Professional Professional Modifier Low / Median / High Price $32.65 / $32.65 / $39.19	Professional		$32.65	$32.65	$39.19