Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.15 / $38.53 / $67.39	Facility		$35.15	$38.53	$67.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $32.47 / $39.20	Professional		$32.15	$32.47	$39.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $32.08 / $47.30 / $161.90	Facility		$32.08	$47.30	$161.90
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $35.36 / $143.25	Professional		$32.15	$35.36	$143.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.33 / $30.33 / $32.15	Facility		$30.33	$30.33	$32.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $32.15 / $39.43	Professional		$32.15	$32.15	$39.43
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $31.52 / $44.16 / $87.17	Facility		$31.52	$44.16	$87.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $43.40 / $78.48	Professional		$32.15	$43.40	$78.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $34.68 / $60.00	Professional		$30.00	$34.68	$60.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $32.11 / $32.15 / $57.45	Facility		$32.11	$32.15	$57.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.87 / $50.44 / $89.82	Facility		$28.87	$50.44	$89.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.29 / $41.32 / $74.69	Professional		$34.29	$41.32	$74.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $32.11 / $35.36 / $64.23	Facility		$32.11	$35.36	$64.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $35.36 / $38.58	Professional		$32.15	$35.36	$38.58
United Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $32.15 / $36.97	Professional		$32.15	$32.15	$36.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $32.15 / $32.45	Professional		$32.15	$32.15	$32.45