Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.26 / $192.43 / $382.73	Facility		$47.26	$192.43	$382.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.72 / $39.94 / $65.41	Professional		$35.72	$39.94	$65.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.58 / $33.08 / $40.49	Professional		$28.58	$33.08	$40.49
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $50.01 / $92.88 / $260.00	Facility		$50.01	$92.88	$260.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $23.52 / $43.34 / $82.20	Professional		$23.52	$43.34	$82.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.29 / $86.40 / $139.32	Facility		$32.29	$86.40	$139.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.90 / $65.05 / $102.72	Professional		$33.90	$65.05	$102.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.91 / $45.95 / $50.54	Professional		$33.91	$45.95	$50.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $47.63 / $52.39 / $105.14	Facility		$47.63	$52.39	$105.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.63 / $71.45 / $130.97	Facility		$47.63	$71.45	$130.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.87 / $42.87 / $42.87	Professional		$42.87	$42.87	$42.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $54.77 / $78.59 / $130.97	Facility		$54.77	$78.59	$130.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $35.72 / $47.63 / $128.44	Professional		$35.72	$47.63	$128.44
United Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $21.43 / $53.35	Professional		$20.00	$21.43	$53.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.43 / $21.43 / $24.67	Professional		$21.43	$21.43	$24.67