Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.87 / $23.03 / $52.63	Professional		$22.87	$23.03	$52.63
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $40.13 / $100.00 / $219.96	Facility		$40.13	$100.00	$219.96
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4.36 / $37.45 / $54.64	Professional		$4.36	$37.45	$54.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.64 / $30.64 / $40.22	Facility		$30.64	$30.64	$40.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.04 / $26.04 / $54.00	Professional		$26.04	$26.04	$54.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $44.02 / $44.02 / $44.02	Facility		$44.02	$44.02	$44.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.02 / $44.02 / $44.02	Professional		$44.02	$44.02	$44.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.58 / $40.65 / $44.71	Professional		$36.58	$40.65	$44.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $44.02 / $46.05 / $52.04	Facility		$44.02	$46.05	$52.04
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $44.02 / $44.02 / $52.04	Professional		$44.02	$44.02	$52.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4.01 / $40.13 / $40.13	Facility		$4.01	$40.13	$40.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.63 / $41.46 / $49.15	Professional		$3.63	$41.46	$49.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $42.74 / $42.74 / $42.74	Facility		$42.74	$42.74	$42.74
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3.58 / $3.58 / $4.36	Professional		$3.58	$3.58	$4.36
United Facility/Professional Professional Modifier Low / Median / High Price $20.79 / $22.75 / $43.74	Professional		$20.79	$22.75	$43.74