Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.18 / $32.65 / $43.60	Facility		$22.18	$32.65	$43.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.80 / $35.46 / $67.13	Professional		$22.80	$35.46	$67.13
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $41.27 / $326.70 / $353.70	Professional	25	$41.27	$326.70	$353.70
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.09 / $16.32 / $23.72	Professional	52	$11.09	$16.32	$23.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.54 / $51.87 / $71.08	Professional		$36.54	$51.87	$71.08
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $33.60 / $33.60 / $51.87	Professional	25	$33.60	$33.60	$51.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $140.72 / $140.72	Facility		$75.00	$140.72	$140.72
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $40.79 / $75.70 / $245.75	Professional		$40.79	$75.70	$245.75
Asuris Northwest Health Facility/Professional Professional Modifier 52 Low / Median / High Price $23.29 / $23.29 / $23.29	Professional	52	$23.29	$23.29	$23.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.82 / $34.82 / $34.82	Professional		$34.82	$34.82	$34.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $32.00 / $58.86 / $98.28	Facility		$32.00	$58.86	$98.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.24 / $55.46 / $92.19	Professional		$30.24	$55.46	$92.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.35 / $54.21 / $95.68	Professional		$9.35	$54.21	$95.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $52.81 / $73.03 / $79.06	Facility		$52.81	$73.03	$79.06
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.55 / $52.55 / $52.55	Facility		$52.55	$52.55	$52.55
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.42 / $69.70 / $100.96	Professional		$45.42	$69.70	$100.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $229.71 / $252.61 / $324.48	Facility		$229.71	$252.61	$324.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $40.69 / $59.28 / $90.10	Professional		$40.69	$59.28	$90.10
United Facility/Professional Professional Modifier Low / Median / High Price $37.67 / $56.63 / $110.17	Professional		$37.67	$56.63	$110.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $32.29 / $32.72 / $42.88	Professional		$32.29	$32.72	$42.88