Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.29 / $75.56 / $78.90	Facility		$33.29	$75.56	$78.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.61 / $33.29 / $78.90	Professional		$28.61	$33.29	$78.90
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $43.20 / $102.58 / $235.40	Facility		$43.20	$102.58	$235.40
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $34.54 / $42.43 / $254.43	Professional		$34.54	$42.43	$254.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.84 / $33.84 / $33.84	Facility		$33.84	$33.84	$33.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.70 / $24.70 / $33.84	Professional		$24.70	$24.70	$33.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $17.52 / $49.34 / $129.37	Facility		$17.52	$49.34	$129.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $17.52 / $49.34 / $95.99	Professional		$17.52	$49.34	$95.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.34 / $49.34 / $60.00	Professional		$49.34	$49.34	$60.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $39.18 / $48.18 / $51.09	Facility		$39.18	$48.18	$51.09
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $44.41 / $49.34 / $51.09	Professional		$44.41	$49.34	$51.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.20 / $55.41 / $96.36	Facility		$43.20	$55.41	$96.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.95 / $40.95 / $48.18	Professional		$40.95	$40.95	$48.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $46.96 / $48.18 / $48.18	Facility		$46.96	$48.18	$48.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $39.20 / $41.94 / $54.27	Professional		$39.20	$41.94	$54.27
United Facility/Professional Professional Modifier Low / Median / High Price $20.83 / $22.57 / $42.98	Professional		$20.83	$22.57	$42.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.86 / $21.86 / $41.94	Professional		$21.86	$21.86	$41.94