Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.37 / $93.91 / $98.05	Facility		$41.37	$93.91	$98.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.70 / $41.37 / $71.56	Professional		$33.70	$41.37	$71.56
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $53.69 / $127.57 / $292.55	Facility		$53.69	$127.57	$292.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $43.66 / $53.35 / $316.33	Professional		$43.66	$53.35	$316.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.07 / $35.07 / $35.07	Facility		$35.07	$35.07	$35.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.60 / $25.60 / $35.07	Professional		$25.60	$25.60	$35.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $26.16 / $61.32 / $160.31	Facility		$26.16	$61.32	$160.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.22 / $61.32 / $119.16	Professional		$29.22	$61.32	$119.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $61.32 / $61.32	Professional		$60.00	$61.32	$61.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $48.65 / $59.88 / $63.52	Facility		$48.65	$59.88	$63.52
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $55.19 / $61.32 / $63.52	Professional		$55.19	$61.32	$63.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.69 / $68.86 / $119.76	Facility		$53.69	$68.86	$119.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.90 / $50.90 / $59.88	Professional		$50.90	$50.90	$59.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $58.36 / $59.88 / $59.88	Facility		$58.36	$59.88	$59.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $48.70 / $52.12 / $67.45	Professional		$48.70	$52.12	$67.45
United Facility/Professional Professional Modifier Low / Median / High Price $25.88 / $30.20 / $53.42	Professional		$25.88	$30.20	$53.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.26 / $19.26 / $52.12	Professional		$19.26	$19.26	$52.12