Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.36 / $52.92 / $65.77	Facility		$33.36	$52.92	$65.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.41 / $38.60 / $58.06	Professional		$24.41	$38.60	$58.06
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $85.57 / $85.57 / $85.57	Professional	25	$85.57	$85.57	$85.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.35 / $45.72 / $82.47	Professional		$40.35	$45.72	$82.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $58.44 / $193.75 / $193.75	Facility		$58.44	$193.75	$193.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $34.26 / $66.98 / $266.08	Professional		$34.26	$66.98	$266.08
Asuris Northwest Health Facility/Professional Professional Modifier 25 Low / Median / High Price $48.89 / $75.59 / $119.02	Professional	25	$48.89	$75.59	$119.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.75 / $66.75 / $136.21	Professional		$37.75	$66.75	$136.21
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $28.47 / $45.99 / $80.76	Facility		$28.47	$45.99	$80.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.47 / $44.64 / $73.81	Professional		$28.47	$44.64	$73.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.90 / $99.42 / $174.58	Professional		$18.90	$99.42	$174.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $57.64 / $90.14 / $110.55	Facility		$57.64	$90.14	$110.55
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.44 / $58.44 / $58.44	Facility		$58.44	$58.44	$58.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.79 / $79.23 / $122.79	Professional		$56.79	$79.23	$122.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $63.79 / $63.79 / $97.86	Facility		$63.79	$63.79	$97.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $56.47 / $101.23	Professional		$34.79	$56.47	$101.23
United Facility/Professional Professional Modifier Low / Median / High Price $55.86 / $80.80 / $127.77	Professional		$55.86	$80.80	$127.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.68 / $45.28 / $58.80	Professional		$41.68	$45.28	$58.80