Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.71 / $161.16 / $688.90	Facility		$55.71	$161.16	$688.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.39 / $36.86 / $62.15	Professional		$19.39	$36.86	$62.15
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $96.00 / $96.00 / $96.00	Professional	25	$96.00	$96.00	$96.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.50 / $25.55 / $56.00	Professional		$20.50	$25.55	$56.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $26.57 / $113.54 / $304.01	Facility		$26.57	$113.54	$304.01
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $23.28 / $36.94 / $228.45	Professional		$23.28	$36.94	$228.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.50 / $37.50 / $37.50	Facility		$37.50	$37.50	$37.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.00 / $40.00 / $75.84	Professional		$21.00	$40.00	$75.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $22.63 / $31.20 / $69.04	Facility		$22.63	$31.20	$69.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $21.59 / $30.24 / $63.16	Professional		$21.59	$30.24	$63.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.02 / $35.74 / $82.48	Professional		$13.02	$35.74	$82.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $33.36 / $48.24 / $56.33	Facility		$33.36	$48.24	$56.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.79 / $35.79 / $35.79	Facility		$35.79	$35.79	$35.79
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.79 / $52.95 / $68.90	Professional		$32.79	$52.95	$68.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $26.57 / $29.12 / $304.01	Facility		$26.57	$29.12	$304.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $22.58 / $31.59 / $40.44	Professional		$22.58	$31.59	$40.44
United Facility/Professional Professional Modifier Low / Median / High Price $28.97 / $40.00 / $74.28	Professional		$28.97	$40.00	$74.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.02 / $25.64 / $30.37	Professional		$24.02	$25.64	$30.37