Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4.61 / $27.95 / $211.44	Facility		$4.61	$27.95	$211.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $4.40 / $32.22	Professional		$4.19	$4.40	$32.22
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $9.19 / $28.49 / $263.20	Facility		$9.19	$28.49	$263.20
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $5.03 / $3,115.14	Professional		$4.19	$5.03	$3,115.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3.95 / $4.19 / $20.52	Facility		$3.95	$4.19	$20.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $4.19 / $10.15	Professional		$4.19	$4.19	$10.15
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4.19 / $67.45 / $258.18	Facility		$4.19	$67.45	$258.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $67.45 / $230.88	Professional		$4.19	$67.45	$230.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $4.60 / $16.19 / $30.00	Professional		$4.60	$16.19	$30.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4.19 / $8.72 / $44.16	Facility		$4.19	$8.72	$44.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $16.68 / $38.49 / $94.62	Facility		$16.68	$38.49	$94.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.42 / $11.41 / $19.47	Professional		$9.42	$11.41	$19.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $9.19 / $13.79 / $57.58	Facility		$9.19	$13.79	$57.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $4.61 / $5.03	Professional		$4.19	$4.61	$5.03
United Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $4.19 / $5.03	Professional		$4.19	$4.19	$5.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $4.19 / $8.46	Professional		$4.19	$4.19	$8.46