Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.99 / $68.12 / $118.02	Facility		$51.99	$68.12	$118.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.04 / $51.99 / $123.22	Professional		$42.04	$51.99	$123.22
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $67.45 / $165.51 / $353.81	Facility		$67.45	$165.51	$353.81
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $49.91 / $66.25 / $389.12	Professional		$49.91	$66.25	$389.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.72 / $36.72 / $36.72	Facility		$36.72	$36.72	$36.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.81 / $26.81 / $51.62	Professional		$26.81	$26.81	$51.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $44.64 / $77.04 / $199.50	Facility		$44.64	$77.04	$199.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.72 / $77.04 / $143.15	Professional		$44.72	$77.04	$143.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.13 / $59.04 / $64.94	Professional		$53.13	$59.04	$64.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $61.14 / $75.06 / $77.04	Facility		$61.14	$75.06	$77.04
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $69.34 / $75.06 / $77.04	Professional		$69.34	$75.06	$77.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.45 / $86.51 / $150.46	Facility		$67.45	$86.51	$150.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.95 / $63.95 / $86.47	Professional		$63.95	$63.95	$86.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $73.31 / $75.23 / $75.23	Facility		$73.31	$75.23	$75.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $61.18 / $65.48 / $84.74	Professional		$61.18	$65.48	$84.74
United Facility/Professional Professional Modifier Low / Median / High Price $31.11 / $33.70 / $64.19	Professional		$31.11	$33.70	$64.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $40.28	Professional		$36.31	$36.31	$40.28