Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.67 / $108.21 / $112.98	Facility		$47.67	$108.21	$112.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.49 / $47.67 / $108.21	Professional		$21.49	$47.67	$108.21
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $64.23 / $139.69 / $338.32	Facility		$64.23	$139.69	$338.32
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $50.41 / $62.36 / $364.44	Professional		$50.41	$62.36	$364.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.82 / $46.82 / $47.76	Facility		$46.82	$46.82	$47.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.18 / $34.18 / $46.82	Professional		$34.18	$34.18	$46.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $40.95 / $73.36 / $185.62	Facility		$40.95	$73.36	$185.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.99 / $73.36 / $137.36	Professional		$40.99	$73.36	$137.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.60 / $56.23 / $61.85	Professional		$50.60	$56.23	$61.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $58.23 / $71.64 / $73.36	Facility		$58.23	$71.64	$73.36
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $58.27 / $73.18 / $73.36	Professional		$58.27	$73.18	$73.36
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $64.23 / $82.39 / $143.28	Facility		$64.23	$82.39	$143.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.54 / $60.89 / $68.98	Professional		$47.54	$60.89	$68.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $69.81 / $71.64 / $71.64	Facility		$69.81	$71.64	$71.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $58.27 / $62.36 / $80.70	Professional		$58.27	$62.36	$80.70
United Facility/Professional Professional Modifier Low / Median / High Price $30.91 / $35.24 / $61.67	Professional		$30.91	$35.24	$61.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.93 / $36.93 / $62.36	Professional		$36.93	$36.93	$62.36