Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.22 / $30.22 / $30.22	Facility		$30.22	$30.22	$30.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.36 / $30.22 / $34.52	Professional		$16.36	$30.22	$34.52
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $36.27 / $63.52 / $169.74	Facility		$36.27	$63.52	$169.74
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $15.93 / $30.83 / $35.42	Professional		$15.93	$30.83	$35.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.60 / $21.60 / $21.60	Professional		$21.60	$21.60	$21.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.02 / $25.02 / $30.59	Professional		$25.02	$25.02	$30.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $35.42 / $35.42 / $79,999.20	Facility		$35.42	$35.42	$79,999.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $33.58 / $33.58 / $33.58	Professional		$33.58	$33.58	$33.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.76 / $55.23 / $89.75	Facility		$31.76	$55.23	$89.75
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.42 / $35.42 / $63.86	Professional		$35.42	$35.42	$63.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $44.94 / $53.93 / $102.46	Facility		$44.94	$53.93	$102.46
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $30.83 / $30.83 / $30.83	Professional		$30.83	$30.83	$30.83
United Facility/Professional Professional Modifier Low / Median / High Price $32.59 / $39.28 / $89.26	Professional		$32.59	$39.28	$89.26