Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.97 / $21.97 / $21.97	Facility		$21.97	$21.97	$21.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.97 / $21.97 / $22.73	Professional		$19.97	$21.97	$22.73
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $19.97 / $85.00 / $90.79	Facility		$19.97	$85.00	$90.79
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $19.97 / $19.97 / $90.79	Professional		$19.97	$19.97	$90.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.84 / $18.84 / $43.00	Facility		$18.84	$18.84	$43.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.97 / $19.97 / $24.49	Professional		$19.97	$19.97	$24.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $19.97 / $19.97 / $26.96	Facility		$19.97	$19.97	$26.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $19.97 / $19.97 / $26.96	Professional		$19.97	$19.97	$26.96
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 $18.98 / $19.97 / $41.45	Facility		$18.98	$19.97	$41.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.47 / $21.47 / $21.72	Facility		$21.47	$21.47	$21.72
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.72 / $22.30 / $37.77	Professional		$21.72	$22.30	$37.77
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $19.97 / $19.97 / $19.97	Facility		$19.97	$19.97	$19.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $18.97 / $19.97 / $19.97	Professional		$18.97	$19.97	$19.97
United Facility/Professional Professional Modifier Low / Median / High Price $19.97 / $19.97 / $23.96	Professional		$19.97	$19.97	$23.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.97 / $19.97 / $20.56	Professional		$19.97	$19.97	$20.56