Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.53 / $46.60 / $48.66	Facility		$20.53	$46.60	$48.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.26 / $20.53 / $49.18	Professional		$11.26	$20.53	$49.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.62 / $30.62 / $30.62	Professional		$30.62	$30.62	$30.62
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $31.73 / $80.00 / $169.60	Facility		$31.73	$80.00	$169.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $24.49 / $32.36 / $180.48	Professional		$24.49	$32.36	$180.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.26 / $24.26 / $24.26	Facility		$24.26	$24.26	$24.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.71 / $17.71 / $28.48	Professional		$17.71	$17.71	$28.48
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $22.94 / $38.45 / $66.19	Facility		$22.94	$38.45	$66.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.94 / $39.97 / $69.51	Professional		$22.94	$39.97	$69.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.73 / $34.97 / $38.46	Professional		$30.73	$34.97	$38.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $28.76 / $35.39 / $36.24	Facility		$28.76	$35.39	$36.24
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $31.67 / $36.24 / $36.24	Professional		$31.67	$36.24	$36.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.08 / $31.73 / $69.01	Facility		$30.08	$31.73	$69.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.08 / $34.33 / $52.08	Professional		$30.08	$34.33	$52.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $34.49 / $35.39 / $35.39	Facility		$34.49	$35.39	$35.39
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $24.47 / $30.80 / $39.86	Professional		$24.47	$30.80	$39.86
United Facility/Professional Professional Modifier Low / Median / High Price $16.27 / $24.52 / $31.04	Professional		$16.27	$24.52	$31.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.78 / $20.78 / $24.17	Professional		$20.78	$20.78	$24.17