Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.34 / $55.65 / $77.06	Facility		$40.34	$55.65	$77.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $38.14 / $55.65	Professional		$36.67	$38.14	$55.65
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $40.34 / $700.41 / $875.51	Facility		$40.34	$700.41	$875.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $48.83 / $1,379.87	Professional		$37.04	$48.83	$1,379.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.59 / $34.59 / $87.02	Facility		$34.59	$34.59	$87.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $36.67 / $44.97	Professional		$36.67	$36.67	$44.97
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $36.67 / $48.48 / $146.63	Facility		$36.67	$48.48	$146.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $48.00 / $118.08	Professional		$36.67	$48.00	$118.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $40.75 / $60.00	Professional		$37.04	$40.75	$60.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $36.67 / $41.94 / $110.01	Facility		$36.67	$41.94	$110.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.45 / $51.53 / $51.53	Facility		$49.45	$51.53	$51.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.45 / $59.60 / $107.73	Professional		$49.45	$59.60	$107.73
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $40.34 / $40.34 / $88.27	Facility		$40.34	$40.34	$88.27
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $40.34 / $44.00	Professional		$36.67	$40.34	$44.00
United Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $36.67 / $45.84	Professional		$36.67	$36.67	$45.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $36.67 / $46.80	Professional		$36.67	$36.67	$46.80