Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.90 / $14.90 / $14.90	Facility		$14.90	$14.90	$14.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.54 / $16.02 / $23.76	Professional		$12.54	$16.02	$23.76
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $29.12 / $134.52 / $140.07	Facility		$29.12	$134.52	$140.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $19.68 / $29.12 / $218.40	Professional		$19.68	$29.12	$218.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.96 / $18.96 / $18.96	Facility		$18.96	$18.96	$18.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.12 / $16.12 / $22.12	Professional		$16.12	$16.12	$22.12
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $18.38 / $33.88 / $72.18	Facility		$18.38	$33.88	$72.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $33.35 / $72.18	Professional		$18.20	$33.35	$72.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.82 / $29.82 / $70.00	Professional		$29.82	$29.82	$70.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $29.12 / $41.80 / $50.92	Facility		$29.12	$41.80	$50.92
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $47.45 / $50.92 / $50.92	Professional		$47.45	$50.92	$50.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.11 / $40.77 / $64.06	Facility		$26.11	$40.77	$64.06
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.75 / $24.75 / $29.12	Professional		$24.75	$24.75	$29.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $28.38 / $29.12 / $29.12	Facility		$28.38	$29.12	$29.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $23.83 / $25.35 / $32.79	Professional		$23.83	$25.35	$32.79
United Facility/Professional Professional Modifier Low / Median / High Price $11.42 / $12.64 / $24.12	Professional		$11.42	$12.64	$24.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $14.40 / $14.40	Professional		$14.40	$14.40	$14.40