Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.58 / $85.31 / $89.06	Facility		$37.58	$85.31	$89.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.70 / $37.58 / $90.04	Professional		$18.70	$37.58	$90.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.43 / $65.00 / $66.33	Professional		$46.43	$65.00	$66.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $58.09 / $311.58 / $311.58	Facility		$58.09	$311.58	$311.58
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $50.40 / $63.01 / $330.32	Professional		$50.40	$63.01	$330.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.86 / $39.86 / $49.23	Facility		$39.86	$39.86	$49.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $33.88 / $49.23	Professional		$33.88	$33.88	$49.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $39.17 / $67.37 / $113.47	Facility		$39.17	$67.37	$113.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.36 / $67.66 / $119.16	Professional		$39.36	$67.66	$119.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.45 / $61.66 / $70.41	Professional		$50.45	$61.66	$70.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $52.66 / $64.78 / $66.33	Facility		$52.66	$64.78	$66.33
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $57.97 / $66.33 / $66.33	Professional		$57.97	$66.33	$66.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $55.06 / $58.09 / $107.41	Facility		$55.06	$58.09	$107.41
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.06 / $62.84 / $95.34	Professional		$55.06	$62.84	$95.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $52.70 / $56.38 / $72.95	Professional		$52.70	$56.38	$72.95
United Facility/Professional Professional Modifier Low / Median / High Price $26.01 / $28.18 / $53.67	Professional		$26.01	$28.18	$53.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.20 / $56.20 / $115.00	Professional		$56.20	$56.20	$115.00