Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.39 / $91.69 / $95.72	Facility		$40.39	$91.69	$95.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.33 / $40.39 / $69.87	Professional		$30.33	$40.39	$69.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $52.40 / $124.42 / $285.48	Facility		$52.40	$124.42	$285.48
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $42.60 / $52.06 / $308.61	Professional		$42.60	$52.06	$308.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.22 / $34.22 / $36.71	Facility		$34.22	$34.22	$36.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.98 / $24.98 / $36.71	Professional		$24.98	$24.98	$36.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $26.16 / $59.84 / $157.50	Facility		$26.16	$59.84	$157.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.22 / $59.84 / $116.67	Professional		$29.22	$59.84	$116.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.75 / $56.39 / $63.52	Professional		$50.75	$56.39	$63.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $47.51 / $58.44 / $61.97	Facility		$47.51	$58.44	$61.97
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $53.86 / $59.84 / $61.97	Professional		$53.86	$59.84	$61.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.40 / $67.20 / $116.88	Facility		$52.40	$67.20	$116.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.67 / $49.67 / $58.44	Professional		$49.67	$49.67	$58.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $56.96 / $58.44 / $58.44	Facility		$56.96	$58.44	$58.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $47.55 / $50.86 / $65.81	Professional		$47.55	$50.86	$65.81
United Facility/Professional Professional Modifier Low / Median / High Price $25.27 / $29.48 / $52.13	Professional		$25.27	$29.48	$52.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $16.64 / $16.64 / $50.86	Professional		$16.64	$16.64	$50.86