Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.31 / $77.88 / $81.31	Facility		$34.31	$77.88	$81.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.48 / $34.31 / $81.31	Professional		$29.48	$34.31	$81.31
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $44.52 / $105.80 / $242.56	Facility		$44.52	$105.80	$242.56
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $36.20 / $44.23 / $262.20	Professional		$36.20	$44.23	$262.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.33 / $36.33 / $36.33	Facility		$36.33	$36.33	$36.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.52 / $26.52 / $36.33	Professional		$26.52	$26.52	$36.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $26.16 / $50.84 / $133.12	Facility		$26.16	$50.84	$133.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.24 / $50.84 / $98.47	Professional		$26.24	$50.84	$98.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.84 / $50.84 / $60.00	Professional		$50.84	$50.84	$60.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $40.36 / $49.65 / $52.65	Facility		$40.36	$49.65	$52.65
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $48.30 / $50.84 / $52.65	Professional		$48.30	$50.84	$52.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.52 / $57.10 / $99.30	Facility		$44.52	$57.10	$99.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.20 / $42.20 / $49.65	Professional		$42.20	$42.20	$49.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $48.39 / $49.65 / $49.65	Facility		$48.39	$49.65	$49.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $40.39 / $43.21 / $55.92	Professional		$40.39	$43.21	$55.92
United Facility/Professional Facility Modifier Low / Median / High Price $17.89 / $23.01 / $29.72	Facility		$17.89	$23.01	$29.72
United Facility/Professional Professional Modifier Low / Median / High Price $21.47 / $23.26 / $44.29	Professional		$21.47	$23.26	$44.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.10 / $24.10 / $43.21	Professional		$24.10	$24.10	$43.21