Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.27 / $39.61 / $192.83	Facility		$30.27	$39.61	$192.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.27 / $35.67 / $62.34	Professional		$30.27	$35.67	$62.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.36 / $38.36 / $38.36	Professional		$38.36	$38.36	$38.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $50.74 / $80.00 / $209.21	Facility		$50.74	$80.00	$209.21
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $51.74 / $89.13 / $349.88	Professional		$51.74	$89.13	$349.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $36.31	Professional		$36.31	$36.31	$36.31
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $32.85 / $61.36 / $92.47	Facility		$32.85	$61.36	$92.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.79 / $66.70 / $95.97	Professional		$33.79	$66.70	$95.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.98 / $51.75 / $93.62	Professional		$9.98	$51.75	$93.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $55.37 / $73.70 / $82.41	Facility		$55.37	$73.70	$82.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.74 / $50.74 / $56.21	Facility		$50.74	$50.74	$56.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.85 / $93.59 / $112.02	Professional		$59.85	$93.59	$112.02
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $51.74 / $75.58 / $105.66	Professional		$51.74	$75.58	$105.66
United Facility/Professional Facility Modifier Low / Median / High Price $39.46 / $39.46 / $39.46	Facility		$39.46	$39.46	$39.46
United Facility/Professional Professional Modifier Low / Median / High Price $41.80 / $55.58 / $110.50	Professional		$41.80	$55.58	$110.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.68 / $33.68 / $33.68	Professional		$33.68	$33.68	$33.68