Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.39 / $96.23 / $100.46	Facility		$42.39	$96.23	$100.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.43 / $42.39 / $100.46	Professional		$36.43	$42.39	$100.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $130.66 / $299.70	Facility		$55.00	$130.66	$299.70
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $43.97 / $54.02 / $324.00	Professional		$43.97	$54.02	$324.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.36 / $38.36 / $38.36	Facility		$38.36	$38.36	$38.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $28.00 / $38.36	Professional		$28.00	$28.00	$38.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $36.40 / $62.81 / $164.06	Facility		$36.40	$62.81	$164.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.44 / $63.49 / $122.47	Professional		$36.44	$63.49	$122.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $62.81 / $62.81	Professional		$60.00	$62.81	$62.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $49.85 / $61.34 / $65.06	Facility		$49.85	$61.34	$65.06
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $56.53 / $62.81 / $65.06	Professional		$56.53	$62.81	$65.06
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $70.54 / $122.68	Facility		$55.00	$70.54	$122.68
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.14 / $52.14 / $61.34	Professional		$52.14	$52.14	$61.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $59.79 / $61.34 / $61.34	Facility		$59.79	$61.34	$61.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $49.90 / $53.39 / $69.09	Professional		$49.90	$53.39	$69.09
United Facility/Professional Professional Modifier Low / Median / High Price $26.52 / $29.85 / $54.73	Professional		$26.52	$29.85	$54.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $29.77 / $29.77 / $53.39	Professional		$29.77	$29.77	$53.39