Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.87 / $39.52 / $62.47	Facility		$23.87	$39.52	$62.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $22.57 / $37.97	Professional		$21.70	$22.57	$37.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $26.66 / $47.14 / $1,715.88	Facility		$26.66	$47.14	$1,715.88
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $23.87 / $933.68	Professional		$21.70	$23.87	$933.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.47 / $21.70 / $57.04	Facility		$20.47	$21.70	$57.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $21.70 / $28.22	Professional		$21.70	$21.70	$28.22
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $21.70 / $44.33 / $124.33	Facility		$21.70	$44.33	$124.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $43.74 / $119.42	Professional		$21.70	$43.74	$119.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $23.87 / $39.60	Professional		$21.70	$23.87	$39.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $19.76 / $24.56 / $61.67	Facility		$19.76	$24.56	$61.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.75 / $59.21 / $99.88	Facility		$31.75	$59.21	$99.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.18 / $31.73 / $54.14	Professional		$26.18	$31.73	$54.14
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $26.66 / $39.99 / $77.31	Facility		$26.66	$39.99	$77.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $23.87 / $26.04	Professional		$21.70	$23.87	$26.04
United Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $21.70 / $26.04	Professional		$21.70	$21.70	$26.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $21.70 / $23.52	Professional		$21.70	$21.70	$23.52