Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.86 / $49.62 / $51.81	Facility		$21.86	$49.62	$51.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.62 / $21.86 / $51.81	Professional		$12.62	$21.86	$51.81
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $29.46 / $75.00 / $134.69	Facility		$29.46	$75.00	$134.69
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $20.35 / $28.60 / $166.57	Professional		$20.35	$28.60	$166.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.89 / $16.89 / $16.89	Facility		$16.89	$16.89	$16.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.34 / $12.34 / $16.89	Professional		$12.34	$12.34	$16.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $15.92 / $31.97 / $72.18	Facility		$15.92	$31.97	$72.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $15.94 / $31.97 / $52.96	Professional		$15.94	$31.97	$52.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.21 / $25.79 / $28.36	Professional		$23.21	$25.79	$28.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $24.64 / $28.97 / $33.65	Facility		$24.64	$28.97	$33.65
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $25.24 / $33.65 / $33.65	Professional		$25.24	$33.65	$33.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.46 / $37.79 / $65.72	Facility		$29.46	$37.79	$65.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.93 / $27.93 / $31.53	Professional		$27.93	$27.93	$31.53
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $32.03 / $32.86 / $32.86	Facility		$32.03	$32.86	$32.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $26.73 / $28.60 / $37.02	Professional		$26.73	$28.60	$37.02
United Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $18.97 / $24.02	Professional		$12.59	$18.97	$24.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $13.53 / $13.53 / $28.60	Professional		$13.53	$13.53	$28.60