Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.31 / $73.34 / $76.56	Facility		$32.31	$73.34	$76.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.74 / $32.31 / $76.56	Professional		$27.74	$32.31	$76.56
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $41.92 / $99.55 / $228.34	Facility		$41.92	$99.55	$228.34
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $34.08 / $41.65 / $246.66	Professional		$34.08	$41.65	$246.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.38 / $27.38 / $27.38	Facility		$27.38	$27.38	$27.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.98 / $19.98 / $27.38	Professional		$19.98	$19.98	$27.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $18.91 / $47.87 / $125.62	Facility		$18.91	$47.87	$125.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $18.91 / $47.87 / $92.68	Professional		$18.91	$47.87	$92.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.87 / $47.87 / $60.00	Professional		$47.87	$47.87	$60.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $38.00 / $46.75 / $49.53	Facility		$38.00	$46.75	$49.53
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $43.08 / $47.87 / $49.53	Professional		$43.08	$47.87	$49.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $41.92 / $53.76 / $93.50	Facility		$41.92	$53.76	$93.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.74 / $39.74 / $46.75	Professional		$39.74	$39.74	$46.75
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $45.57 / $46.75 / $46.75	Facility		$45.57	$46.75	$46.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $40.69 / $52.66	Professional		$38.02	$40.69	$52.66
United Facility/Professional Professional Modifier Low / Median / High Price $20.21 / $21.89 / $41.70	Professional		$20.21	$21.89	$41.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.70 / $40.69 / $40.69	Professional		$26.70	$40.69	$40.69