Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.13 / $75.20 / $94.84	Facility		$33.13	$75.20	$94.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.45 / $33.13 / $70.48	Professional		$29.45	$33.13	$70.48
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $27.13 / $121.84 / $275.93	Facility		$27.13	$121.84	$275.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $23.76 / $54.36 / $420.15	Professional		$23.76	$54.36	$420.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.67 / $57.67 / $57.67	Facility		$57.67	$57.67	$57.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.10 / $42.10 / $78.95	Professional		$42.10	$42.10	$78.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $26.55 / $96.96 / $182.02	Facility		$26.55	$96.96	$182.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.55 / $96.96 / $168.81	Professional		$26.55	$96.96	$168.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $68.07 / $75.64 / $83.20	Professional		$68.07	$75.64	$83.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $27.95 / $62.70 / $81.06	Facility		$27.95	$62.70	$81.06
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $27.95 / $41.65 / $81.06	Professional		$27.95	$41.65	$81.06
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $37.97 / $41.95 / $70.13	Facility		$37.97	$41.95	$70.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.06 / $23.06 / $91.27	Professional		$23.06	$23.06	$91.27
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $27.13 / $27.13 / $43.83	Facility		$27.13	$27.13	$43.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $22.57 / $24.04 / $78.38	Professional		$22.57	$24.04	$78.38
United Facility/Professional Professional Modifier Low / Median / High Price $41.66 / $45.05 / $75.09	Professional		$41.66	$45.05	$75.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.36 / $72.84 / $72.84	Professional		$54.36	$72.84	$72.84