Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.64 / $46.85 / $48.92	Facility		$20.64	$46.85	$48.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.14 / $20.64 / $48.92	Professional		$13.14	$20.64	$48.92
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $27.81 / $75.00 / $132.87	Facility		$27.81	$75.00	$132.87
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $19.62 / $27.00 / $157.21	Professional		$19.62	$27.00	$157.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.62 / $16.62 / $16.62	Facility		$16.62	$16.62	$16.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.13 / $12.13 / $16.62	Professional		$12.13	$12.13	$16.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $15.47 / $30.23 / $71.25	Facility		$15.47	$30.23	$71.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $15.48 / $30.17 / $52.96	Professional		$15.48	$30.17	$52.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.90 / $24.34 / $26.77	Professional		$21.90	$24.34	$26.77
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $25.19 / $28.58 / $31.76	Facility		$25.19	$28.58	$31.76
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $26.28 / $31.76 / $31.76	Professional		$26.28	$31.76	$31.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.81 / $35.67 / $62.04	Facility		$27.81	$35.67	$62.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.37 / $26.37 / $32.32	Professional		$26.37	$26.37	$32.32
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $30.23 / $31.02 / $31.02	Facility		$30.23	$31.02	$31.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $25.22 / $27.00 / $34.94	Professional		$25.22	$27.00	$34.94
United Facility/Professional Facility Modifier Low / Median / High Price $16.25 / $16.25 / $16.25	Facility		$16.25	$16.25	$16.25
United Facility/Professional Professional Modifier Low / Median / High Price $12.40 / $18.69 / $23.67	Professional		$12.40	$18.69	$23.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $6.24 / $6.24 / $27.00	Professional		$6.24	$6.24	$27.00