Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.59 / $164.93 / $405.68	Facility		$40.59	$164.93	$405.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.58 / $31.23 / $55.50	Professional		$29.58	$31.23	$55.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.56 / $24.54 / $72.63	Professional		$23.56	$24.54	$72.63
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $41.22 / $80.00 / $186.49	Facility		$41.22	$80.00	$186.49
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $16.76 / $35.33 / $64.00	Professional		$16.76	$35.33	$64.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.49 / $80.39 / $119.82	Facility		$23.49	$80.39	$119.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.59 / $48.75 / $67.69	Professional		$23.59	$48.75	$67.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.95 / $37.86 / $41.65	Professional		$27.95	$37.86	$41.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $39.26 / $39.26 / $86.67	Facility		$39.26	$39.26	$86.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.33 / $39.26 / $39.26	Facility		$35.33	$39.26	$39.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.33 / $35.33 / $35.33	Professional		$35.33	$35.33	$35.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $45.15 / $64.43 / $107.97	Facility		$45.15	$64.43	$107.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $29.45 / $39.26 / $105.99	Professional		$29.45	$39.26	$105.99
United Facility/Professional Facility Modifier Low / Median / High Price $39.26 / $47.11 / $47.11	Facility		$39.26	$47.11	$47.11
United Facility/Professional Professional Modifier Low / Median / High Price $16.48 / $16.48 / $39.26	Professional		$16.48	$16.48	$39.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.34 / $20.34 / $20.34	Professional		$20.34	$20.34	$20.34