Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.60 / $69.45 / $1,424.53	Facility		$30.60	$69.45	$1,424.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.88 / $30.60 / $40.85	Professional		$29.88	$30.60	$40.85
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $34.20 / $34.20 / $135.00	Facility		$34.20	$34.20	$135.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $30.78 / $34.20 / $162.00	Professional		$30.78	$34.20	$162.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.60 / $30.60 / $61.20	Facility		$30.60	$30.60	$61.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.60 / $30.60 / $30.60	Professional		$30.60	$30.60	$30.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $23.87 / $59.87 / $86.60	Facility		$23.87	$59.87	$86.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $23.87 / $59.87 / $89.44	Professional		$23.87	$59.87	$89.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.61 / $37.61 / $75.00	Professional		$37.61	$37.61	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $34.20 / $34.20 / $65.66	Facility		$34.20	$34.20	$65.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $34.20 / $34.20 / $34.20	Facility		$34.20	$34.20	$34.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.20 / $34.20 / $34.20	Professional		$34.20	$34.20	$34.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $34.20 / $34.20 / $34.20	Facility		$34.20	$34.20	$34.20
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $32.49 / $34.20 / $34.20	Professional		$32.49	$34.20	$34.20
United Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $36.00	Professional		$30.00	$30.00	$36.00