Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.51 / $25.96 / $33.89	Facility		$22.51	$25.96	$33.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.18 / $22.51 / $26.38	Professional		$21.18	$22.51	$26.38
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $23.39 / $36.72 / $116.95	Facility		$23.39	$36.72	$116.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $22.51 / $100.62 / $119.16	Professional		$22.51	$100.62	$119.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.51 / $23.39 / $56.72	Facility		$22.51	$23.39	$56.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.51 / $22.51 / $22.51	Professional		$22.51	$22.51	$22.51
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $23.39 / $51.36 / $83.97	Facility		$23.39	$51.36	$83.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.37 / $45.84 / $65.18	Professional		$27.37	$45.84	$65.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $75.00 / $75.00	Professional		$30.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $32.04 / $79,999.20 / $79,999.20	Facility		$32.04	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.05 / $35.79 / $65.50	Facility		$21.05	$35.79	$65.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.39 / $22.51 / $27.80	Professional		$20.39	$22.51	$27.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $23.39 / $29.24 / $54.98	Facility		$23.39	$29.24	$54.98
United Facility/Professional Professional Modifier Low / Median / High Price $22.07 / $22.07 / $26.48	Professional		$22.07	$22.07	$26.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.07 / $22.07 / $22.07	Professional		$22.07	$22.07	$22.07