Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.22 / $14.22 / $14.22	Facility		$14.22	$14.22	$14.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.28 / $14.51 / $18.23	Professional		$13.28	$14.51	$18.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.33 / $33.33 / $33.33	Professional		$33.33	$33.33	$33.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $15.00 / $190.76 / $190.76	Facility		$15.00	$190.76	$190.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $17.50 / $17.50 / $356.03	Professional		$17.50	$17.50	$356.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $14.50 / $65.75	Professional		$10.00	$14.50	$65.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $20.00 / $43.86 / $206.38	Facility		$20.00	$43.86	$206.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $20.60 / $55.88	Professional		$20.00	$20.60	$55.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $17.00 / $28.33 / $28.33	Facility		$17.00	$28.33	$28.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.00 / $15.00 / $15.00	Facility		$15.00	$15.00	$15.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $15.00 / $15.00	Professional		$15.00	$15.00	$15.00
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 $17.50 / $17.50 / $17.50	Professional		$17.50	$17.50	$17.50
United Facility/Professional Professional Modifier Low / Median / High Price $49.60 / $81.13 / $122.54	Professional		$49.60	$81.13	$122.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.62 / $44.98 / $48.28	Professional		$22.62	$44.98	$48.28