Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.39 / $91.69 / $95.72	Facility		$40.39	$91.69	$95.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.70 / $40.39 / $91.69	Professional		$34.70	$40.39	$91.69
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $52.40 / $124.42 / $285.48	Facility		$52.40	$124.42	$285.48
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $42.60 / $52.06 / $308.61	Professional		$42.60	$52.06	$308.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.72 / $36.72 / $36.72	Facility		$36.72	$36.72	$36.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.81 / $26.81 / $36.72	Professional		$26.81	$26.81	$36.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $34.58 / $59.84 / $157.50	Facility		$34.58	$59.84	$157.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.61 / $60.77 / $116.67	Professional		$34.61	$60.77	$116.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.84 / $59.84 / $60.00	Professional		$59.84	$59.84	$60.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $47.51 / $58.44 / $61.97	Facility		$47.51	$58.44	$61.97
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $53.86 / $59.84 / $61.97	Professional		$53.86	$59.84	$61.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.40 / $67.20 / $116.88	Facility		$52.40	$67.20	$116.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.67 / $49.67 / $58.44	Professional		$49.67	$49.67	$58.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $56.96 / $58.44 / $58.44	Facility		$56.96	$58.44	$58.44
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $47.55 / $50.86 / $65.81	Professional		$47.55	$50.86	$65.81
United Facility/Professional Professional Modifier Low / Median / High Price $25.27 / $29.48 / $52.13	Professional		$25.27	$29.48	$52.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.86 / $50.86	Professional		$32.36	$50.86	$50.86