Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.39 / $24.39 / $24.39	Facility		$24.39	$24.39	$24.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.95 / $24.39 / $24.39	Professional		$22.95	$24.39	$24.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $23.81 / $85.00 / $107.59	Facility		$23.81	$85.00	$107.59
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $24.38 / $109.02 / $129.11	Professional		$24.38	$109.02	$129.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.39 / $24.39 / $78.20	Facility		$24.39	$24.39	$78.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.39 / $24.39 / $24.39	Professional		$24.39	$24.39	$24.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.26 / $39.26 / $39.26	Professional		$39.26	$39.26	$39.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $16.91 / $16.91 / $79,999.20	Facility		$16.91	$16.91	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.81 / $23.81 / $24.39	Facility		$23.81	$23.81	$24.39
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.09 / $24.39 / $25.82	Professional		$22.09	$24.39	$25.82
United Facility/Professional Professional Modifier Low / Median / High Price $28.69 / $28.69 / $34.43	Professional		$28.69	$28.69	$34.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.69 / $28.69 / $28.69	Professional		$28.69	$28.69	$28.69