Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.97 / $17.46 / $40.35	Professional		$11.97	$17.46	$40.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.56 / $25.56 / $30.43	Professional		$25.56	$25.56	$30.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $30.61 / $100.00 / $167.12	Facility		$30.61	$100.00	$167.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3.51 / $28.33 / $41.47	Professional		$3.51	$28.33	$41.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.28 / $23.28 / $30.56	Facility		$23.28	$23.28	$30.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.79 / $23.28 / $30.56	Professional		$19.79	$23.28	$30.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $32.88 / $32.88 / $32.88	Facility		$32.88	$32.88	$32.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.88 / $32.88 / $32.88	Professional		$32.88	$32.88	$32.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.32 / $32.58 / $35.83	Professional		$29.32	$32.58	$35.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $32.88 / $34.90 / $40.81	Facility		$32.88	$34.90	$40.81
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $29.59 / $34.90 / $40.22	Professional		$29.59	$34.90	$40.22
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3.07 / $30.61 / $30.61	Facility		$3.07	$30.61	$30.61
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2.71 / $27.13 / $36.71	Professional		$2.71	$27.13	$36.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $31.92 / $31.92 / $31.92	Facility		$31.92	$31.92	$31.92
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2.88 / $2.88 / $3.51	Professional		$2.88	$2.88	$3.51
United Facility/Professional Professional Modifier Low / Median / High Price $16.66 / $17.27 / $33.19	Professional		$16.66	$17.27	$33.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.10 / $26.10 / $28.33	Professional		$26.10	$26.10	$28.33