Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.12 / $25.49 / $56.87	Professional		$22.12	$25.49	$56.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.65 / $46.65 / $62.20	Professional		$46.65	$46.65	$62.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $42.87 / $100.00 / $222.30	Facility		$42.87	$100.00	$222.30
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $6.08 / $37.54 / $65.31	Professional		$6.08	$37.54	$65.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.00 / $31.00 / $41.50	Facility		$31.00	$31.00	$41.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.35 / $31.00 / $45.36	Professional		$26.35	$31.00	$45.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $44.16 / $44.16 / $44.16	Facility		$44.16	$44.16	$44.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.16 / $44.16 / $44.16	Professional		$44.16	$44.16	$44.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.16 / $56.45 / $67.89	Professional		$45.16	$56.45	$67.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $44.16 / $44.23 / $71.92	Facility		$44.16	$44.23	$71.92
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $41.95 / $44.23 / $62.20	Professional		$41.95	$44.23	$62.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4.48 / $4.48 / $49.30	Facility		$4.48	$4.48	$49.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.65 / $36.44 / $90.17	Professional		$3.65	$36.44	$90.17
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $42.87 / $42.87 / $42.87	Facility		$42.87	$42.87	$42.87
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4.99 / $4.99 / $6.08	Professional		$4.99	$4.99	$6.08
United Facility/Professional Professional Modifier Low / Median / High Price $25.11 / $32.56 / $48.22	Professional		$25.11	$32.56	$48.22
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $76.09 / $76.09	Professional		$76.09	$76.09	$76.09