Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.04 / $33.04 / $33.04	Facility		$33.04	$33.04	$33.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.63 / $34.85 / $52.55	Professional		$32.63	$34.85	$52.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.70 / $48.70 / $48.70	Professional		$48.70	$48.70	$48.70
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $56.39 / $160.00 / $283.33	Facility		$56.39	$160.00	$283.33
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $41.81 / $54.15 / $401.03	Professional		$41.81	$54.15	$401.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.36 / $40.36 / $49.86	Facility		$40.36	$40.36	$49.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.31 / $34.31 / $49.86	Professional		$34.31	$34.31	$49.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $16.77 / $58.08 / $126.73	Facility		$16.77	$58.08	$126.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $20.64 / $63.03 / $131.19	Professional		$20.64	$63.03	$131.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $60.00 / $80.00	Professional		$30.00	$60.00	$80.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $58.08 / $70.56 / $79.98	Facility		$58.08	$70.56	$79.98
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $58.08 / $62.19 / $77.45	Professional		$58.08	$62.19	$77.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.00 / $78.95 / $124.06	Facility		$57.00	$78.95	$124.06
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.93 / $47.93 / $47.93	Professional		$47.93	$47.93	$47.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $56.39 / $56.39 / $60.42	Facility		$56.39	$56.39	$60.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $46.90 / $49.37 / $63.89	Professional		$46.90	$49.37	$63.89
United Facility/Professional Professional Modifier Low / Median / High Price $30.37 / $38.72 / $58.30	Professional		$30.37	$38.72	$58.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.72 / $38.72 / $38.72	Professional		$38.72	$38.72	$38.72