Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.09 / $53.09 / $79.25	Facility		$53.09	$53.09	$79.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.61 / $51.54 / $78.18	Professional		$25.61	$51.54	$78.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.60 / $45.60 / $45.60	Professional		$45.60	$45.60	$45.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $91.13 / $116.64 / $166.92	Facility		$91.13	$116.64	$166.92
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $59.27 / $140.51 / $488.59	Professional		$59.27	$140.51	$488.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.29 / $50.29 / $50.29	Professional		$50.29	$50.29	$50.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $24.71 / $54.44 / $104.86	Facility		$24.71	$54.44	$104.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.71 / $53.94 / $95.72	Professional		$24.71	$53.94	$95.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $60.00	Professional		$50.00	$50.00	$60.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $72.52 / $110.88 / $146.72	Facility		$72.52	$110.88	$146.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.08 / $103.74 / $103.74	Facility		$100.08	$103.74	$103.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.51 / $105.12 / $182.46	Professional		$61.51	$105.12	$182.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $93.42 / $109.35 / $157.82	Facility		$93.42	$109.35	$157.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $94.83 / $131.10 / $180.63	Professional		$94.83	$131.10	$180.63
United Facility/Professional Professional Modifier Low / Median / High Price $81.41 / $109.16 / $218.50	Professional		$81.41	$109.16	$218.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.66 / $46.66 / $55.35	Professional		$46.66	$46.66	$55.35