Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.68 / $65.09 / $67.97	Facility		$28.68	$65.09	$67.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.21 / $28.68 / $28.68	Professional		$16.21	$28.68	$28.68
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $36.49 / $150.43 / $150.43	Facility		$36.49	$150.43	$150.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $23.85 / $37.44 / $247.43	Professional		$23.85	$37.44	$247.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.58 / $28.58 / $28.58	Facility		$28.58	$28.58	$28.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.86 / $20.86 / $28.58	Professional		$20.86	$20.86	$28.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $26.66 / $59.98 / $96.77	Facility		$26.66	$59.98	$96.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.66 / $56.57 / $78.06	Professional		$26.66	$56.57	$78.06
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 $46.75 / $51.71 / $56.95	Facility		$46.75	$51.71	$56.95
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $47.83 / $47.83 / $47.83	Professional		$47.83	$47.83	$47.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.85 / $38.85 / $38.85	Professional		$38.85	$38.85	$38.85
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $35.36 / $42.44 / $77.54	Facility		$35.36	$42.44	$77.54
United Facility/Professional Professional Modifier Low / Median / High Price $18.26 / $20.25 / $30.68	Professional		$18.26	$20.25	$30.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.82 / $20.82 / $54.56	Professional		$20.82	$20.82	$54.56