Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.04 / $86.37 / $90.18	Facility		$38.04	$86.37	$90.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.27 / $38.04 / $90.18	Professional		$29.27	$38.04	$90.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $51.26 / $124.20 / $304.39	Facility		$51.26	$124.20	$304.39
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $42.73 / $51.23 / $325.36	Professional		$42.73	$51.23	$325.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.25 / $37.25 / $37.25	Facility		$37.25	$37.25	$37.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.19 / $27.19 / $37.25	Professional		$27.19	$27.19	$37.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $36.85 / $62.28 / $160.41	Facility		$36.85	$62.28	$160.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.89 / $62.44 / $124.12	Professional		$36.89	$62.44	$124.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.39 / $44.88 / $49.36	Professional		$40.39	$44.88	$49.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $46.48 / $57.17 / $58.54	Facility		$46.48	$57.17	$58.54
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $52.69 / $58.54 / $64.39	Professional		$52.69	$58.54	$64.39
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.26 / $65.75 / $114.34	Facility		$51.26	$65.75	$114.34
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.59 / $48.59 / $50.17	Professional		$48.59	$48.59	$50.17
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $55.72 / $57.17 / $57.17	Facility		$55.72	$57.17	$57.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $46.51 / $49.76 / $64.39	Professional		$46.51	$49.76	$64.39
United Facility/Professional Professional Modifier Low / Median / High Price $29.21 / $44.00 / $55.72	Professional		$29.21	$44.00	$55.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.99 / $37.99 / $49.76	Professional		$37.99	$37.99	$49.76