Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.19 / $19.19 / $19.19	Facility		$19.19	$19.19	$19.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.89 / $19.43 / $34.76	Professional		$17.89	$19.43	$34.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.36 / $36.43 / $39.15	Professional		$29.36	$36.43	$39.15
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $50.40 / $222.53 / $222.53	Facility		$50.40	$222.53	$222.53
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $31.63 / $36.50 / $416.85	Professional		$31.63	$36.50	$416.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.00 / $28.84 / $65.75	Professional		$21.00	$28.84	$65.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $51.00 / $206.38	Facility		$30.00	$51.00	$206.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $32.00 / $65.12	Professional		$30.00	$32.00	$65.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.17 / $41.21 / $50.00	Professional		$19.17	$41.21	$50.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $17.89 / $29.81 / $29.81	Facility		$17.89	$29.81	$29.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.40 / $50.40 / $50.40	Facility		$50.40	$50.40	$50.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.40 / $50.40 / $50.40	Professional		$50.40	$50.40	$50.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $198.15 / $198.15 / $304.01	Facility		$198.15	$198.15	$304.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $36.50 / $36.50 / $36.50	Professional		$36.50	$36.50	$36.50
United Facility/Professional Professional Modifier Low / Median / High Price $58.00 / $85.56 / $140.01	Professional		$58.00	$85.56	$140.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.92 / $33.85 / $38.97	Professional		$23.92	$33.85	$38.97