Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.90 / $83.76 / $87.45	Facility		$36.90	$83.76	$87.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.01 / $36.90 / $87.45	Professional		$31.01	$36.90	$87.45
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $49.72 / $136.93 / $253.42	Facility		$49.72	$136.93	$253.42
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $37.21 / $48.84 / $432.68	Professional		$37.21	$48.84	$432.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.78 / $29.78 / $29.78	Facility		$29.78	$29.78	$29.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.74 / $21.74 / $29.78	Professional		$21.74	$21.74	$29.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $30.03 / $56.79 / $136.87	Facility		$30.03	$56.79	$136.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.06 / $54.99 / $101.78	Professional		$30.06	$54.99	$101.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.18 / $43.54 / $47.89	Professional		$39.18	$43.54	$47.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $45.08 / $55.46 / $62.01	Facility		$45.08	$55.46	$62.01
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $51.11 / $56.79 / $62.01	Professional		$51.11	$56.79	$62.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.72 / $63.78 / $110.92	Facility		$49.72	$63.78	$110.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.14 / $47.14 / $96.15	Professional		$47.14	$47.14	$96.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $54.05 / $55.46 / $55.46	Facility		$54.05	$55.46	$55.46
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $45.12 / $48.27 / $62.47	Professional		$45.12	$48.27	$62.47
United Facility/Professional Professional Modifier Low / Median / High Price $23.77 / $35.65 / $45.36	Professional		$23.77	$35.65	$45.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $10.41 / $10.41 / $28.86	Professional		$10.41	$10.41	$28.86