Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.21 / $57.23 / $59.75	Facility		$25.21	$57.23	$59.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.69 / $25.21 / $59.75	Professional		$21.69	$25.21	$59.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $32.71 / $85.00 / $178.31	Facility		$32.71	$85.00	$178.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $26.61 / $32.50 / $192.88	Professional		$26.61	$32.50	$192.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.64 / $25.64 / $25.64	Facility		$25.64	$25.64	$25.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.72 / $18.72 / $25.64	Professional		$18.72	$18.72	$25.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $14.57 / $37.36 / $98.43	Facility		$14.57	$37.36	$98.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $14.57 / $37.36 / $72.81	Professional		$14.57	$37.36	$72.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.36 / $37.36 / $60.00	Professional		$37.36	$37.36	$60.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $29.65 / $36.47 / $38.72	Facility		$29.65	$36.47	$38.72
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $33.61 / $37.36 / $38.72	Professional		$33.61	$37.36	$38.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $32.71 / $41.95 / $72.95	Facility		$32.71	$41.95	$72.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.01 / $31.01 / $36.47	Professional		$31.01	$31.01	$36.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $35.56 / $36.47 / $36.47	Facility		$35.56	$36.47	$36.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $29.67 / $31.76 / $41.10	Professional		$29.67	$31.76	$41.10
United Facility/Professional Professional Modifier Low / Median / High Price $15.77 / $17.09 / $32.56	Professional		$15.77	$17.09	$32.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.84 / $31.76 / $31.76	Professional		$20.84	$31.76	$31.76