Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.00 / $95.34 / $99.54	Facility		$42.00	$95.34	$99.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.04 / $42.00 / $83.20	Professional		$32.04	$42.00	$83.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.42 / $53.42 / $53.42	Professional		$53.42	$53.42	$53.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $51.86 / $80.00 / $250.01	Facility		$51.86	$80.00	$250.01
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $45.41 / $45.41 / $388.95	Professional		$45.41	$45.41	$388.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.75 / $39.75 / $39.75	Professional		$39.75	$39.75	$39.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $53.42 / $53.42 / $73.45	Facility		$53.42	$53.42	$73.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.42 / $61.43 / $140.02	Professional		$53.42	$61.43	$140.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $85.00 / $85.00	Professional		$50.00	$85.00	$85.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $45.20 / $51.86 / $58.76	Facility		$45.20	$51.86	$58.76
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $48.08 / $53.42 / $58.76	Professional		$48.08	$53.42	$58.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $93.35 / $134.84	Facility		$55.00	$93.35	$134.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $55.00 / $55.00	Professional		$55.00	$55.00	$55.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $51.86 / $51.86 / $51.86	Facility		$51.86	$51.86	$51.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $43.14 / $45.41 / $53.42	Professional		$43.14	$45.41	$53.42
United Facility/Professional Professional Modifier Low / Median / High Price $31.12 / $51.86 / $51.86	Professional		$31.12	$51.86	$51.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $45.41 / $45.41 / $60.11	Professional		$45.41	$45.41	$60.11