Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.26 / $64.15 / $66.98	Facility		$28.26	$64.15	$66.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.28 / $28.26 / $66.98	Professional		$24.28	$28.26	$66.98
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $36.67 / $87.09 / $199.79	Facility		$36.67	$87.09	$199.79
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $29.82 / $36.44 / $215.93	Professional		$29.82	$36.44	$215.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.67 / $26.67 / $26.67	Facility		$26.67	$26.67	$26.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.47 / $19.47 / $34.32	Professional		$19.47	$19.47	$34.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $17.44 / $41.88 / $109.68	Facility		$17.44	$41.88	$109.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $19.48 / $41.88 / $81.92	Professional		$19.48	$41.88	$81.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.52 / $40.40 / $44.45	Professional		$35.52	$40.40	$44.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $33.24 / $40.90 / $43.36	Facility		$33.24	$40.90	$43.36
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $33.26 / $41.88 / $43.36	Professional		$33.26	$41.88	$43.36
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.67 / $47.04 / $81.80	Facility		$36.67	$47.04	$81.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.77 / $34.77 / $40.90	Professional		$34.77	$34.77	$40.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $39.86 / $40.90 / $40.90	Facility		$39.86	$40.90	$40.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $33.26 / $35.60 / $46.07	Professional		$33.26	$35.60	$46.07
United Facility/Professional Professional Modifier Low / Median / High Price $17.68 / $19.14 / $36.47	Professional		$17.68	$19.14	$36.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.82 / $20.82 / $35.60	Professional		$20.82	$20.82	$35.60