Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.96 / $55.29 / $75.75	Facility		$31.96	$55.29	$75.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.46 / $31.96 / $32.34	Professional		$30.46	$31.96	$32.34
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $35.72 / $35.72 / $138.08	Facility		$35.72	$35.72	$138.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $35.72 / $35.72 / $264.89	Professional		$35.72	$35.72	$264.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.96 / $31.96 / $63.92	Facility		$31.96	$31.96	$63.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.96 / $31.96 / $31.96	Professional		$31.96	$31.96	$31.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $27.28 / $68.51 / $85.10	Facility		$27.28	$68.51	$85.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.28 / $68.51 / $86.06	Professional		$27.28	$68.51	$86.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.29 / $39.29 / $75.00	Professional		$39.29	$39.29	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $35.72 / $35.72 / $60.97	Facility		$35.72	$35.72	$60.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.72 / $35.72 / $35.72	Facility		$35.72	$35.72	$35.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.72 / $35.72 / $35.72	Professional		$35.72	$35.72	$35.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $35.72 / $35.72 / $35.72	Facility		$35.72	$35.72	$35.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $33.93 / $35.72 / $35.72	Professional		$33.93	$35.72	$35.72
United Facility/Professional Professional Modifier Low / Median / High Price $37.60 / $37.60 / $37.60	Professional		$37.60	$37.60	$37.60