Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.38 / $54.54 / $116.34	Facility		$29.38	$54.54	$116.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $28.05 / $49.68	Professional		$26.71	$28.05	$49.68
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $30.75 / $49.20 / $224.95	Facility		$30.75	$49.20	$224.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $30.71 / $1,801.12	Professional		$26.71	$30.71	$1,801.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.20 / $26.71 / $71.59	Facility		$25.20	$26.71	$71.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $26.71 / $32.76	Professional		$26.71	$26.71	$32.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $26.71 / $58.66 / $158.41	Facility		$26.71	$58.66	$158.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $61.13 / $145.52	Professional		$26.71	$61.13	$145.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.38 / $33.35 / $48.43	Professional		$29.38	$33.35	$48.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $26.71 / $33.39 / $78.36	Facility		$26.71	$33.39	$78.36
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.89 / $51.39 / $86.78	Facility		$27.89	$51.39	$86.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.86 / $37.60 / $67.95	Professional		$32.86	$37.60	$67.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $30.75 / $42.05 / $73.00	Facility		$30.75	$42.05	$73.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $29.38 / $32.04	Professional		$26.71	$29.38	$32.04
United Facility/Professional Facility Modifier Low / Median / High Price $50.03 / $50.03 / $50.03	Facility		$50.03	$50.03	$50.03
United Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $26.71 / $32.04	Professional		$26.71	$26.71	$32.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $26.71 / $29.52	Professional		$26.71	$26.71	$29.52