Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.80 / $63.68 / $248.00	Facility		$48.80	$63.68	$248.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $33.22 / $57.47	Professional		$26.71	$33.22	$57.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $43.10 / $95.95 / $258.76	Facility		$43.10	$95.95	$258.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $35.93 / $43.07 / $324.87	Professional		$35.93	$43.07	$324.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.92 / $31.92 / $31.92	Facility		$31.92	$31.92	$31.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.30 / $23.30 / $31.92	Professional		$23.30	$23.30	$31.92
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $30.94 / $52.29 / $134.87	Facility		$30.94	$52.29	$134.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.97 / $52.31 / $104.26	Professional		$30.97	$52.31	$104.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.95 / $37.72 / $41.50	Professional		$33.95	$37.72	$41.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $39.08 / $48.07 / $49.22	Facility		$39.08	$48.07	$49.22
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $39.08 / $49.22 / $54.14	Professional		$39.08	$49.22	$54.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.10 / $55.28 / $96.14	Facility		$43.10	$55.28	$96.14
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.86 / $40.86 / $48.36	Professional		$40.86	$40.86	$48.36
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $46.85 / $48.07 / $48.07	Facility		$46.85	$48.07	$48.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $39.10 / $41.84 / $54.14	Professional		$39.10	$41.84	$54.14
United Facility/Professional Professional Modifier Low / Median / High Price $22.70 / $24.60 / $46.85	Professional		$22.70	$24.60	$46.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $29.46 / $40.34 / $40.34	Professional		$29.46	$40.34	$40.34