Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.17 / $104.81 / $109.42	Facility		$46.17	$104.81	$109.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.67 / $44.20 / $109.42	Professional		$32.67	$44.20	$109.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $59.91 / $123.60 / $286.64	Facility		$59.91	$123.60	$286.64
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $46.15 / $59.91 / $338.63	Professional		$46.15	$59.91	$338.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.68 / $36.61 / $36.61	Facility		$21.68	$36.61	$36.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.73 / $26.73 / $45.60	Professional		$26.73	$26.73	$45.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $36.00 / $68.41 / $187.50	Facility		$36.00	$68.41	$187.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.13 / $67.90 / $115.85	Professional		$38.13	$67.90	$115.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.20 / $52.45 / $57.69	Professional		$47.20	$52.45	$57.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $53.14 / $59.86 / $68.41	Facility		$53.14	$59.86	$68.41
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $54.42 / $68.41 / $68.41	Professional		$54.42	$68.41	$68.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $56.79 / $59.91 / $130.28	Facility		$56.79	$59.91	$130.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.79 / $64.81 / $98.33	Professional		$56.79	$64.81	$98.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $65.12 / $66.81 / $66.81	Facility		$65.12	$66.81	$66.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $54.35 / $58.15 / $75.25	Professional		$54.35	$58.15	$75.25
United Facility/Professional Professional Modifier Low / Median / High Price $25.32 / $27.20 / $51.80	Professional		$25.32	$27.20	$51.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $35.78 / $35.78 / $58.15	Professional		$35.78	$35.78	$58.15