Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.35 / $36.35 / $36.35	Facility		$36.35	$36.35	$36.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $36.35 / $64.27	Professional		$34.85	$36.35	$64.27
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $65.09 / $179.65 / $310.80	Facility		$65.09	$179.65	$310.80
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $47.92 / $62.81 / $630.37	Professional		$47.92	$62.81	$630.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.23 / $44.23 / $54.64	Facility		$44.23	$44.23	$54.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.60 / $37.60 / $54.64	Professional		$37.60	$37.60	$54.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $57.35 / $107.22 / $262.23	Facility		$57.35	$107.22	$262.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.88 / $101.75 / $248.68	Professional		$54.88	$101.75	$248.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $60.00 / $80.00	Professional		$30.00	$60.00	$80.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $67.06 / $73.81 / $79.98	Facility		$67.06	$73.81	$79.98
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $60.35 / $67.06 / $76.37	Professional		$60.35	$67.06	$76.37
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.81 / $91.14 / $143.22	Facility		$62.81	$91.14	$143.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.34 / $55.34 / $55.34	Professional		$55.34	$55.34	$55.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $65.09 / $65.09 / $66.77	Facility		$65.09	$65.09	$66.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $54.15 / $57.00 / $73.77	Professional		$54.15	$57.00	$73.77
United Facility/Professional Facility Modifier Low / Median / High Price $34.85 / $42.60 / $59.90	Facility		$34.85	$42.60	$59.90
United Facility/Professional Professional Modifier Low / Median / High Price $32.20 / $40.76 / $61.98	Professional		$32.20	$40.76	$61.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.17 / $42.17 / $42.17	Professional		$42.17	$42.17	$42.17