Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.68 / $43.06 / $90.36	Facility		$23.68	$43.06	$90.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.53 / $22.60 / $40.04	Professional		$21.53	$22.60	$40.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $23.68 / $688.70 / $875.64	Facility		$23.68	$688.70	$875.64
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $21.69 / $25.83 / $971.75	Professional		$21.69	$25.83	$971.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.30 / $20.30 / $43.12	Facility		$20.30	$20.30	$43.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.52 / $21.52 / $26.40	Professional		$21.52	$21.52	$26.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $21.53 / $28.69 / $63.51	Facility		$21.53	$28.69	$63.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $21.53 / $29.14 / $65.17	Professional		$21.53	$29.14	$65.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.53 / $23.68 / $32.34	Professional		$21.53	$23.68	$32.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $20.90 / $24.37 / $62.70	Facility		$20.90	$24.37	$62.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $24.66 / $39.04 / $39.04	Facility		$24.66	$39.04	$39.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.28 / $26.64 / $48.14	Professional		$23.28	$26.64	$48.14
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $23.68 / $23.68 / $23.68	Facility		$23.68	$23.68	$23.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $21.53 / $23.68 / $25.83	Professional		$21.53	$23.68	$25.83
United Facility/Professional Professional Modifier Low / Median / High Price $21.53 / $21.53 / $26.91	Professional		$21.53	$21.53	$26.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.91 / $21.53 / $21.53	Professional		$20.91	$21.53	$21.53