Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.37 / $57.04 / $59.32	Facility		$31.37	$57.04	$59.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $28.80 / $34.51	Professional		$28.52	$28.80	$34.51
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $33.90 / $50.87 / $143.93	Facility		$33.90	$50.87	$143.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $31.37 / $172.71	Professional		$28.52	$31.37	$172.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.90 / $28.52 / $65.23	Facility		$26.90	$28.52	$65.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $28.52 / $34.97	Professional		$28.52	$28.52	$34.97
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $28.52 / $28.81 / $111.88	Facility		$28.52	$28.81	$111.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $28.52 / $51.00	Professional		$28.52	$28.52	$51.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $31.37 / $75.00	Professional		$28.52	$31.37	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $26.90 / $28.52 / $59.19	Facility		$26.90	$28.52	$59.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.51 / $51.87 / $94.93	Facility		$30.51	$51.87	$94.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.55 / $32.61 / $40.29	Professional		$29.55	$32.61	$40.29
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $33.90 / $40.69 / $75.50	Facility		$33.90	$40.69	$75.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $31.37 / $34.22	Professional		$28.52	$31.37	$34.22
United Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $28.52 / $35.65	Professional		$28.52	$28.52	$35.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $28.52 / $31.99	Professional		$28.52	$28.52	$31.99