Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.34 / $84.76 / $88.50	Facility		$37.34	$84.76	$88.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.07 / $37.34 / $64.59	Professional		$28.07	$37.34	$64.59
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $48.45 / $115.12 / $264.05	Facility		$48.45	$115.12	$264.05
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $39.40 / $48.15 / $285.55	Professional		$39.40	$48.15	$285.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.65 / $31.65 / $31.65	Facility		$31.65	$31.65	$31.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.10 / $23.10 / $31.65	Professional		$23.10	$23.10	$31.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $31.72 / $55.34 / $144.37	Facility		$31.72	$55.34	$144.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.85 / $55.34 / $106.74	Professional		$31.85	$55.34	$106.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.34 / $55.34 / $60.00	Professional		$55.34	$55.34	$60.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $43.93 / $54.04 / $57.34	Facility		$43.93	$54.04	$57.34
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $49.81 / $55.34 / $57.34	Professional		$49.81	$55.34	$57.34
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $48.45 / $62.15 / $108.08	Facility		$48.45	$62.15	$108.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.93 / $45.93 / $54.04	Professional		$45.93	$45.93	$54.04
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $52.67 / $54.04 / $54.04	Facility		$52.67	$54.04	$54.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $43.96 / $47.04 / $60.87	Professional		$43.96	$47.04	$60.87
United Facility/Professional Facility Modifier Low / Median / High Price $19.47 / $25.04 / $27.26	Facility		$19.47	$25.04	$27.26
United Facility/Professional Professional Modifier Low / Median / High Price $23.36 / $25.31 / $48.21	Professional		$23.36	$25.31	$48.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $47.04 / $62.45 / $62.45	Professional		$47.04	$62.45	$62.45