Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.78 / $28.14 / $162.90	Facility		$10.78	$28.14	$162.90
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $39.35 / $139.79 / $417.00	Facility	25	$39.35	$139.79	$417.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.99 / $21.10 / $39.54	Professional		$7.99	$21.10	$39.54
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $18.03 / $27.88 / $67.00	Professional	25	$18.03	$27.88	$67.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.79 / $35.72 / $48.97	Professional		$19.79	$35.72	$48.97
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $20.78 / $25.99 / $59.92	Professional	25	$20.78	$25.99	$59.92
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $50.00 / $50.00	Facility		$50.00	$50.00	$50.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $13.36 / $38.99 / $220.00	Professional		$13.36	$38.99	$220.00
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $16.45 / $29.32 / $50.50	Professional	25	$16.45	$29.32	$50.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.10 / $125.00 / $148.00	Facility		$30.10	$125.00	$148.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.52 / $25.51 / $62.53	Professional		$11.52	$25.51	$62.53
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $10.66 / $21.16 / $50.47	Facility		$10.66	$21.16	$50.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $10.13 / $21.22 / $50.75	Professional		$10.13	$21.22	$50.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.02 / $52.61 / $95.68	Professional		$9.02	$52.61	$95.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $23.09 / $38.52 / $46.90	Facility		$23.09	$38.52	$46.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.80 / $30.80 / $30.80	Facility		$30.80	$30.80	$30.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $30.35 / $58.45	Professional		$14.40	$30.35	$58.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $12.94 / $28.57 / $54.36	Professional		$12.94	$28.57	$54.36
United Facility/Professional Facility Modifier Low / Median / High Price $49.00 / $49.00 / $49.00	Facility		$49.00	$49.00	$49.00
United Facility/Professional Professional Modifier Low / Median / High Price $23.23 / $35.29 / $65.54	Professional		$23.23	$35.29	$65.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $9.11 / $19.32 / $26.47	Professional		$9.11	$19.32	$26.47