Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.01 / $61.31 / $102.00	Facility		$27.01	$61.31	$102.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.19 / $24.90 / $42.82	Professional		$20.19	$24.90	$42.82
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $35.04 / $91.39 / $196.70	Facility		$35.04	$91.39	$196.70
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $28.28 / $34.25 / $232.65	Professional		$28.28	$34.25	$232.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.97 / $29.97 / $29.97	Facility		$29.97	$29.97	$29.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $21.88 / $29.97	Professional		$21.88	$21.88	$29.97
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $22.75 / $40.02 / $103.12	Facility		$22.75	$40.02	$103.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.77 / $40.02 / $76.95	Professional		$22.77	$40.02	$76.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.61 / $30.68 / $33.74	Professional		$27.61	$30.68	$33.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $31.76 / $36.04 / $40.02	Facility		$31.76	$36.04	$40.02
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $36.02 / $40.02 / $40.02	Professional		$36.02	$40.02	$40.02
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.04 / $44.94 / $78.16	Facility		$35.04	$44.94	$78.16
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.22 / $33.22 / $42.33	Professional		$33.22	$33.22	$42.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $38.09 / $39.08 / $39.08	Facility		$38.09	$39.08	$39.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $31.79 / $34.02 / $44.02	Professional		$31.79	$34.02	$44.02
United Facility/Professional Professional Modifier Low / Median / High Price $16.63 / $18.02 / $34.31	Professional		$16.63	$18.02	$34.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $12.49 / $34.02	Professional		$12.49	$12.49	$34.02