Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.42 / $98.56 / $102.91	Facility		$43.42	$98.56	$102.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.29 / $43.42 / $102.91	Professional		$37.29	$43.42	$102.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $56.33 / $133.76 / $306.82	Facility		$56.33	$133.76	$306.82
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $45.80 / $55.97 / $331.67	Professional		$45.80	$55.97	$331.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.78 / $36.78 / $36.78	Facility		$36.78	$36.78	$36.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.85 / $26.85 / $41.71	Professional		$26.85	$26.85	$41.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $26.16 / $64.33 / $168.75	Facility		$26.16	$64.33	$168.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.22 / $64.33 / $124.95	Professional		$29.22	$64.33	$124.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.55 / $62.08 / $68.28	Professional		$54.55	$62.08	$68.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $51.05 / $62.82 / $66.59	Facility		$51.05	$62.82	$66.59
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $61.11 / $64.33 / $66.59	Professional		$61.11	$64.33	$66.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $56.33 / $72.23 / $125.64	Facility		$56.33	$72.23	$125.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.40 / $53.40 / $62.82	Professional		$53.40	$53.40	$62.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $61.23 / $62.82 / $62.82	Facility		$61.23	$62.82	$62.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $51.10 / $54.68 / $70.76	Professional		$51.10	$54.68	$70.76
United Facility/Professional Facility Modifier Low / Median / High Price $78.48 / $94.18 / $94.18	Facility		$78.48	$94.18	$94.18
United Facility/Professional Professional Modifier Low / Median / High Price $27.15 / $29.41 / $56.03	Professional		$27.15	$29.41	$56.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.30 / $20.30 / $54.68	Professional		$20.30	$20.30	$54.68