Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.33 / $89.28 / $93.21	Facility		$39.33	$89.28	$93.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.84 / $39.33 / $93.21	Professional		$33.84	$39.33	$93.21
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $51.04 / $121.31 / $278.23	Facility		$51.04	$121.31	$278.23
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $41.53 / $50.71 / $300.94	Professional		$41.53	$50.71	$300.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.35 / $33.35 / $33.35	Facility		$33.35	$33.35	$33.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.35 / $24.35 / $37.83	Professional		$24.35	$24.35	$37.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $23.68 / $58.29 / $152.81	Facility		$23.68	$58.29	$152.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $23.74 / $58.29 / $112.54	Professional		$23.74	$58.29	$112.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.29 / $58.29 / $60.00	Professional		$58.29	$58.29	$60.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.28 / $56.92 / $60.43	Facility		$46.28	$56.92	$60.43
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $52.46 / $58.29 / $60.43	Professional		$52.46	$58.29	$60.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.04 / $65.45 / $113.84	Facility		$51.04	$65.45	$113.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.38 / $48.38 / $56.92	Professional		$48.38	$48.38	$56.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $55.48 / $56.92 / $56.92	Facility		$55.48	$56.92	$56.92
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $46.31 / $49.55 / $64.12	Professional		$46.31	$49.55	$64.12
United Facility/Professional Facility Modifier Low / Median / High Price $71.17 / $85.40 / $85.40	Facility		$71.17	$85.40	$85.40
United Facility/Professional Professional Modifier Low / Median / High Price $24.62 / $26.63 / $50.80	Professional		$24.62	$26.63	$50.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $15.61 / $15.61 / $49.55	Professional		$15.61	$15.61	$49.55