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 / $15.00 / $26.58	Professional		$13.28	$15.00	$26.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.82 / $18.75 / $18.75	Professional		$17.82	$18.75	$18.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $15.00 / $151.40 / $151.40	Facility		$15.00	$151.40	$151.40
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $15.50 / $288.14	Professional		$15.00	$15.50	$288.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $14.42 / $40.44	Professional		$10.00	$14.42	$40.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $28.56 / $39.78 / $81.54	Facility		$28.56	$39.78	$81.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.56 / $38.27 / $56.41	Professional		$28.56	$38.27	$56.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.65 / $13.91 / $31.62	Professional		$12.65	$13.91	$31.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $12.62 / $21.02 / $21.03	Facility		$12.62	$21.02	$21.03
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 $15.50 / $15.50 / $15.50	Professional		$15.50	$15.50	$15.50
United Facility/Professional Facility Modifier Low / Median / High Price $313.58 / $343.12 / $438.58	Facility		$313.58	$343.12	$438.58
United Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $65.44 / $96.56	Professional		$40.00	$65.44	$96.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $82.36 / $88.96	Professional		$15.00	$82.36	$88.96