Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.26 / $50.00 / $64.31	Facility		$26.26	$50.00	$64.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.88 / $24.83 / $50.85	Professional		$23.88	$24.83	$50.85
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $29.06 / $82.67 / $3,290.10	Facility		$29.06	$82.67	$3,290.10
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $24.43 / $30.43 / $1,372.11	Professional		$24.43	$30.43	$1,372.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.53 / $23.88 / $109.44	Facility		$22.53	$23.88	$109.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.88 / $23.88 / $29.28	Professional		$23.88	$23.88	$29.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $23.88 / $41.96 / $146.12	Facility		$23.88	$41.96	$146.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $23.88 / $37.77 / $85.32	Professional		$23.88	$37.77	$85.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.26 / $30.45 / $44.40	Professional		$26.26	$30.45	$44.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $23.88 / $29.85 / $96.40	Facility		$23.88	$29.85	$96.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $37.04 / $72.23 / $122.02	Facility		$37.04	$72.23	$122.02
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.70 / $77.45 / $140.01	Professional		$67.70	$77.45	$140.01
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $27.27 / $55.11 / $110.22	Facility		$27.27	$55.11	$110.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $23.88 / $26.27 / $28.65	Professional		$23.88	$26.27	$28.65
United Facility/Professional Professional Modifier Low / Median / High Price $23.88 / $23.88 / $29.85	Professional		$23.88	$23.88	$29.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.88 / $23.88 / $60.82	Professional		$23.88	$23.88	$60.82