Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.46 / $87.30 / $91.15	Facility		$38.46	$87.30	$91.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.64 / $38.46 / $91.15	Professional		$27.64	$38.46	$91.15
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $51.82 / $112.20 / $279.95	Facility		$51.82	$112.20	$279.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $42.25 / $51.82 / $364.82	Professional		$42.25	$51.82	$364.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.54 / $34.54 / $34.54	Facility		$34.54	$34.54	$34.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.21 / $25.21 / $34.54	Professional		$25.21	$25.21	$34.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $34.58 / $59.18 / $158.43	Facility		$34.58	$59.18	$158.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.61 / $60.36 / $117.50	Professional		$34.61	$60.36	$117.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.82 / $45.36 / $49.89	Professional		$40.82	$45.36	$49.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.98 / $55.27 / $59.18	Facility		$46.98	$55.27	$59.18
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $50.30 / $59.18 / $59.18	Professional		$50.30	$59.18	$59.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.82 / $66.45 / $115.58	Facility		$51.82	$66.45	$115.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.12 / $49.12 / $57.55	Professional		$49.12	$49.12	$57.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $56.33 / $57.79 / $57.79	Facility		$56.33	$57.79	$57.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $47.01 / $50.30 / $65.09	Professional		$47.01	$50.30	$65.09
United Facility/Professional Professional Modifier Low / Median / High Price $27.58 / $41.50 / $52.61	Professional		$27.58	$41.50	$52.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.69 / $22.69 / $50.30	Professional		$22.69	$22.69	$50.30