Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.63 / $69.53 / $72.59	Facility		$30.63	$69.53	$72.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.80 / $30.63 / $72.59	Professional		$16.80	$30.63	$72.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.67 / $48.67 / $52.81	Professional		$48.67	$48.67	$52.81
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $47.35 / $102.98 / $253.09	Facility		$47.35	$102.98	$253.09
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $36.52 / $48.26 / $269.32	Professional		$36.52	$48.26	$269.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.21 / $36.21 / $36.21	Facility		$36.21	$36.21	$36.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.43 / $26.43 / $42.48	Professional		$26.43	$26.43	$42.48
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $34.10 / $56.90 / $98.50	Facility		$34.10	$56.90	$98.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.10 / $59.17 / $103.43	Professional		$34.10	$59.17	$103.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.86 / $52.19 / $57.40	Professional		$45.86	$52.19	$57.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $42.94 / $52.81 / $54.08	Facility		$42.94	$52.81	$54.08
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $47.26 / $54.08 / $54.08	Professional		$47.26	$54.08	$54.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.89 / $47.35 / $102.98	Facility		$44.89	$47.35	$102.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.89 / $51.23 / $77.72	Professional		$44.89	$51.23	$77.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $51.47 / $52.81 / $52.81	Facility		$51.47	$52.81	$52.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $36.52 / $45.97 / $59.49	Professional		$36.52	$45.97	$59.49
United Facility/Professional Professional Modifier Low / Median / High Price $24.28 / $36.59 / $46.32	Professional		$24.28	$36.59	$46.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.02 / $31.02 / $34.94	Professional		$31.02	$31.02	$34.94