Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.76 / $90.26 / $94.23	Facility		$39.76	$90.26	$94.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.78 / $39.76 / $94.23	Professional		$28.78	$39.76	$94.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $53.58 / $152.00 / $306.17	Facility		$53.58	$152.00	$306.17
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $44.66 / $54.49 / $480.51	Professional		$44.66	$54.49	$480.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.97 / $35.97 / $35.97	Facility		$35.97	$35.97	$35.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.26 / $26.26 / $35.97	Professional		$26.26	$26.26	$35.97
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $36.40 / $61.59 / $165.00	Facility		$36.40	$61.59	$165.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.44 / $62.40 / $122.47	Professional		$36.44	$62.40	$122.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.21 / $46.91 / $51.60	Professional		$42.21	$46.91	$51.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $48.58 / $57.56 / $61.18	Facility		$48.58	$57.56	$61.18
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $55.06 / $61.18 / $67.30	Professional		$55.06	$61.18	$67.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.58 / $68.70 / $119.50	Facility		$53.58	$68.70	$119.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.79 / $50.79 / $50.79	Professional		$50.79	$50.79	$50.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $58.24 / $59.75 / $59.75	Facility		$58.24	$59.75	$59.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $48.61 / $52.00 / $67.30	Professional		$48.61	$52.00	$67.30
United Facility/Professional Professional Modifier Low / Median / High Price $28.72 / $43.07 / $54.79	Professional		$28.72	$43.07	$54.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $12.49 / $52.00	Professional		$12.49	$12.49	$52.00