Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.86 / $78.04 / $213.35	Facility		$33.86	$78.04	$213.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.80 / $30.71 / $57.60	Professional		$28.80	$30.71	$57.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.32 / $20.32 / $23.51	Professional		$20.32	$20.32	$23.51
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $35.54 / $67.72 / $161.58	Facility		$35.54	$67.72	$161.58
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $16.72 / $30.47 / $54.94	Professional		$16.72	$30.47	$54.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $61.43 / $99.05	Facility		$23.44	$61.43	$99.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.59 / $44.66 / $67.69	Professional		$23.59	$44.66	$67.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.11 / $32.65 / $35.92	Professional		$24.11	$32.65	$35.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $33.86 / $35.54 / $222.66	Facility		$33.86	$35.54	$222.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.86 / $50.79 / $93.12	Facility		$33.86	$50.79	$93.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.47 / $30.47 / $30.47	Professional		$30.47	$30.47	$30.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $38.94 / $55.87 / $93.12	Facility		$38.94	$55.87	$93.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $25.40 / $33.86 / $91.62	Professional		$25.40	$33.86	$91.62
United Facility/Professional Professional Modifier Low / Median / High Price $14.22 / $14.22 / $37.92	Professional		$14.22	$14.22	$37.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $15.24 / $15.24 / $17.54	Professional		$15.24	$15.24	$17.54