Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.36 / $41.68 / $43.51	Facility		$18.36	$41.68	$43.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.78 / $18.36 / $43.51	Professional		$15.78	$18.36	$43.51
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $23.83 / $75.00 / $131.74	Facility		$23.83	$75.00	$131.74
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $19.67 / $23.67 / $141.22	Professional		$19.67	$23.67	$141.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $15.80 / $15.80 / $15.80	Facility		$15.80	$15.80	$15.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.53 / $11.53 / $17.94	Professional		$11.53	$11.53	$17.94
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $15.92 / $27.21 / $72.18	Facility		$15.92	$27.21	$72.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $15.94 / $27.75 / $53.78	Professional		$15.94	$27.75	$53.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.21 / $27.21 / $60.00	Professional		$27.21	$27.21	$60.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $21.60 / $26.57 / $28.17	Facility		$21.60	$26.57	$28.17
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $21.60 / $27.21 / $28.17	Professional		$21.60	$27.21	$28.17
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.83 / $30.56 / $53.14	Facility		$23.83	$30.56	$53.14
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.58 / $22.58 / $26.57	Professional		$22.58	$22.58	$26.57
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $25.90 / $26.57 / $26.57	Facility		$25.90	$26.57	$26.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $21.62 / $23.13 / $29.93	Professional		$21.62	$23.13	$29.93
United Facility/Professional Professional Modifier Low / Median / High Price $11.66 / $12.64 / $24.07	Professional		$11.66	$12.64	$24.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $14.97 / $14.97 / $15.39	Professional		$14.97	$14.97	$15.39