Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.00 / $61.29 / $63.99	Facility		$27.00	$61.29	$63.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.26 / $27.00 / $27.00	Professional		$15.26	$27.00	$27.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $34.35 / $141.59 / $141.59	Facility		$34.35	$141.59	$141.59
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $19.03 / $39.11 / $232.88	Professional		$19.03	$39.11	$232.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.60 / $27.60 / $27.60	Facility		$27.60	$27.60	$27.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.14 / $20.14 / $27.60	Professional		$20.14	$20.14	$27.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $25.11 / $56.49 / $91.08	Facility		$25.11	$56.49	$91.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.11 / $53.36 / $73.52	Professional		$25.11	$53.36	$73.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $41.85 / $48.67 / $53.60	Facility		$41.85	$48.67	$53.60
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $41.85 / $41.85 / $41.85	Professional		$41.85	$41.85	$41.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.56 / $36.56 / $36.56	Professional		$36.56	$36.56	$36.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $33.29 / $39.95 / $72.98	Facility		$33.29	$39.95	$72.98
United Facility/Professional Professional Modifier Low / Median / High Price $17.17 / $19.05 / $28.87	Professional		$17.17	$19.05	$28.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $18.73 / $18.73 / $47.96	Professional		$18.73	$18.73	$47.96