Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.79 / $107.80 / $326.89	Facility		$46.79	$107.80	$326.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.43 / $58.76 / $294.00	Professional		$45.43	$58.76	$294.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.90 / $79.77 / $111.09	Professional		$53.90	$79.77	$111.09
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $89.20 / $144.25 / $276.56	Facility		$89.20	$144.25	$276.56
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $63.61 / $123.27 / $456.68	Professional		$63.61	$123.27	$456.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.80 / $48.80 / $48.80	Professional		$48.80	$48.80	$48.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $28.14 / $80.09 / $164.33	Facility		$28.14	$80.09	$164.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.24 / $75.06 / $133.22	Professional		$32.24	$75.06	$133.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.45 / $106.95 / $185.15	Professional		$18.45	$106.95	$185.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $73.01 / $104.12 / $109.21	Facility		$73.01	$104.12	$109.21
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.39 / $94.90 / $111.88	Facility		$73.39	$94.90	$111.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.06 / $124.25 / $148.78	Professional		$79.06	$124.25	$148.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $67.83 / $81.39 / $114.04	Facility		$67.83	$81.39	$114.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $74.84 / $104.37 / $141.16	Professional		$74.84	$104.37	$141.16
United Facility/Professional Professional Modifier Low / Median / High Price $47.21 / $88.09 / $162.97	Professional		$47.21	$88.09	$162.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $45.28 / $45.28 / $59.09	Professional		$45.28	$45.28	$59.09