Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.10 / $34.95 / $59.84	Facility		$23.10	$34.95	$59.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.57 / $25.25 / $82.00	Professional		$20.57	$25.25	$82.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $32.76 / $80.00 / $178.59	Facility		$32.76	$80.00	$178.59
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $27.04 / $32.76 / $193.12	Professional		$27.04	$32.76	$193.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13.65 / $24.80 / $24.80	Facility		$13.65	$24.80	$24.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.10 / $18.10 / $24.80	Professional		$18.10	$18.10	$24.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $22.56 / $38.52 / $102.53	Facility		$22.56	$38.52	$102.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.18 / $39.71 / $72.81	Professional		$24.18	$39.71	$72.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.81 / $28.68 / $31.54	Professional		$25.81	$28.68	$31.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $33.68 / $37.42 / $41.16	Facility		$33.68	$37.42	$41.16
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $29.72 / $29.72 / $29.72	Professional		$29.72	$29.72	$29.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.06 / $32.76 / $71.25	Facility		$31.06	$32.76	$71.25
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.06 / $35.44 / $53.77	Professional		$31.06	$35.44	$53.77
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $35.61 / $36.54 / $36.54	Facility		$35.61	$36.54	$36.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $29.72 / $31.81 / $41.16	Professional		$29.72	$31.81	$41.16
United Facility/Professional Professional Modifier Low / Median / High Price $16.09 / $18.44 / $32.61	Professional		$16.09	$18.44	$32.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.75 / $31.81 / $31.81	Professional		$20.75	$31.81	$31.81