Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.35 / $44.71 / $52.32	Facility		$31.35	$44.71	$52.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.50 / $31.35 / $44.71	Professional		$29.50	$31.35	$44.71
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $28.66 / $42.99 / $171.75	Facility		$28.66	$42.99	$171.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $31.35 / $678.95 / $678.95	Professional		$31.35	$678.95	$678.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.35 / $31.35 / $62.70	Facility		$31.35	$31.35	$62.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.35 / $31.35 / $31.35	Professional		$31.35	$31.35	$31.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $25.96 / $53.47 / $107.46	Facility		$25.96	$53.47	$107.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.96 / $50.92 / $87.46	Professional		$25.96	$50.92	$87.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.73 / $33.80 / $75.00	Professional		$30.73	$33.80	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $44.19 / $79,999.20 / $79,999.20	Facility		$44.19	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.69 / $32.57 / $74.59	Facility		$27.69	$32.57	$74.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.40 / $31.35 / $38.72	Professional		$28.40	$31.35	$38.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $28.66 / $35.83 / $83.11	Facility		$28.66	$35.83	$83.11
United Facility/Professional Professional Modifier Low / Median / High Price $30.73 / $30.73 / $36.88	Professional		$30.73	$30.73	$36.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.73 / $30.73 / $30.73	Professional		$30.73	$30.73	$30.73