Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.99 / $95.57 / $168.21	Facility		$59.99	$95.57	$168.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.17 / $63.03 / $163.96	Professional		$31.17	$63.03	$163.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.63 / $51.63 / $51.63	Professional		$51.63	$51.63	$51.63
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $81.99 / $744.18 / $1,455.83	Facility		$81.99	$744.18	$1,455.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $56.26 / $119.28 / $478.96	Professional		$56.26	$119.28	$478.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.66 / $102.66 / $102.66	Facility		$102.66	$102.66	$102.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.97 / $85.76 / $179.85	Professional		$42.97	$85.76	$179.85
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $42.72 / $79.59 / $163.94	Facility		$42.72	$79.59	$163.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.72 / $79.36 / $154.00	Professional		$42.72	$79.36	$154.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.01 / $101.72 / $178.72	Professional		$18.01	$101.72	$178.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $64.98 / $114.63 / $130.65	Facility		$64.98	$114.63	$130.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.60 / $81.99 / $89.12	Facility		$28.60	$81.99	$89.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.06 / $89.80 / $155.86	Professional		$55.06	$89.80	$155.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $493.52 / $761.06 / $1,455.83	Facility		$493.52	$761.06	$1,455.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $50.40 / $83.62 / $148.74	Professional		$50.40	$83.62	$148.74
United Facility/Professional Facility Modifier Low / Median / High Price $151.00 / $648.00 / $5,793.00	Facility		$151.00	$648.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $76.91 / $99.68 / $177.65	Professional		$76.91	$99.68	$177.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $35.01 / $55.49 / $74.87	Professional		$35.01	$55.49	$74.87