Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.42 / $125.63 / $354.16	Facility		$56.42	$125.63	$354.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.10 / $56.42 / $66.12	Professional		$55.10	$56.42	$66.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $6.86 / $6.86 / $82.00	Professional		$6.86	$6.86	$82.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $63.06 / $85.00 / $248.93	Facility		$63.06	$85.00	$248.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $56.75 / $63.06 / $298.70	Professional		$56.75	$63.06	$298.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.42 / $56.42 / $112.84	Facility		$56.42	$56.42	$112.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.42 / $56.42 / $56.42	Professional		$56.42	$56.42	$56.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $60.14 / $141.50 / $173.95	Facility		$60.14	$141.50	$173.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.14 / $141.50 / $176.64	Professional		$60.14	$141.50	$176.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.36 / $69.36 / $75.00	Professional		$69.36	$69.36	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79,999.20 / $79,999.20 / $79,999.20	Facility		$79,999.20	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.06 / $63.06 / $63.06	Facility		$63.06	$63.06	$63.06
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.06 / $63.06 / $63.06	Professional		$63.06	$63.06	$63.06
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $63.06 / $63.06 / $63.06	Facility		$63.06	$63.06	$63.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $59.91 / $63.06 / $63.06	Professional		$59.91	$63.06	$63.06
United Facility/Professional Facility Modifier Low / Median / High Price $266.63 / $266.63 / $266.63	Facility		$266.63	$266.63	$266.63
United Facility/Professional Professional Modifier Low / Median / High Price $56.50 / $56.50 / $67.80	Professional		$56.50	$56.50	$67.80