Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.18 / $48.08 / $50.20	Facility		$21.18	$48.08	$50.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.21 / $21.18 / $50.20	Professional		$14.21	$21.18	$50.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $28.53 / $75.00 / $134.22	Facility		$28.53	$75.00	$134.22
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $19.94 / $27.69 / $161.27	Professional		$19.94	$27.69	$161.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.30 / $16.30 / $16.30	Facility		$16.30	$16.30	$16.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.91 / $11.91 / $16.30	Professional		$11.91	$11.91	$16.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $16.38 / $31.29 / $73.12	Facility		$16.38	$31.29	$73.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $16.39 / $30.95 / $54.61	Professional		$16.39	$30.95	$54.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.48 / $24.98 / $27.47	Professional		$22.48	$24.98	$27.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $25.88 / $29.32 / $32.58	Facility		$25.88	$29.32	$32.58
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $25.89 / $29.32 / $32.58	Professional		$25.89	$29.32	$32.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.53 / $36.59 / $63.64	Facility		$28.53	$36.59	$63.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.05 / $27.05 / $28.76	Professional		$27.05	$27.05	$28.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $31.01 / $31.82 / $31.82	Facility		$31.01	$31.82	$31.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $25.89 / $27.69 / $35.84	Professional		$25.89	$27.69	$35.84
United Facility/Professional Professional Modifier Low / Median / High Price $12.83 / $19.34 / $24.49	Professional		$12.83	$19.34	$24.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $9.36 / $9.36 / $27.69	Professional		$9.36	$9.36	$27.69