Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.33 / $114.25 / $119.28	Facility		$50.33	$114.25	$119.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.60 / $50.33 / $87.07	Professional		$27.60	$50.33	$87.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.20 / $79.97 / $88.85	Professional		$62.20	$79.97	$88.85
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $77.80 / $169.20 / $415.82	Facility		$77.80	$169.20	$415.82
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $60.02 / $79.30 / $442.47	Professional		$60.02	$79.30	$442.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.47 / $59.47 / $59.47	Facility		$59.47	$59.47	$59.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.41 / $43.41 / $69.80	Professional		$43.41	$43.41	$69.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $55.57 / $90.63 / $161.54	Facility		$55.57	$90.63	$161.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.11 / $92.81 / $169.63	Professional		$56.11	$92.81	$169.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.35 / $83.73 / $94.31	Professional		$75.35	$83.73	$94.31
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $70.93 / $86.77 / $88.85	Facility		$70.93	$86.77	$88.85
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $77.63 / $88.85 / $88.85	Professional		$77.63	$88.85	$88.85
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.75 / $77.80 / $169.20	Facility		$73.75	$77.80	$169.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.75 / $84.17 / $127.70	Professional		$73.75	$84.17	$127.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $84.57 / $86.77 / $86.77	Facility		$84.57	$86.77	$86.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $59.98 / $75.52 / $97.74	Professional		$59.98	$75.52	$97.74
United Facility/Professional Professional Modifier Low / Median / High Price $39.89 / $60.08 / $76.11	Professional		$39.89	$60.08	$76.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.08 / $54.08 / $57.66	Professional		$54.08	$54.08	$57.66