Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.54 / $30.54 / $53.35	Facility		$30.54	$30.54	$53.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.54 / $45.97 / $70.48	Professional		$30.54	$45.97	$70.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $98.13 / $104.13	Professional		$87.10	$98.13	$104.13
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $81.09 / $190.65 / $190.65	Facility		$81.09	$190.65	$190.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $48.84 / $93.35 / $383.21	Professional		$48.84	$93.35	$383.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.99 / $49.99 / $53.34	Professional		$49.99	$49.99	$53.34
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $34.40 / $57.96 / $101.55	Facility		$34.40	$57.96	$101.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.40 / $57.89 / $101.55	Professional		$34.40	$57.89	$101.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $96.33 / $161.44	Professional		$18.62	$96.33	$161.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $66.47 / $110.79 / $121.72	Facility		$66.47	$110.79	$121.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.09 / $81.09 / $81.09	Facility		$81.09	$81.09	$81.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.55 / $93.40 / $149.66	Professional		$57.55	$93.40	$149.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $198.15 / $198.15 / $304.01	Facility		$198.15	$198.15	$304.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $52.21 / $82.70 / $124.16	Professional		$52.21	$82.70	$124.16
United Facility/Professional Professional Modifier Low / Median / High Price $76.14 / $113.18 / $182.40	Professional		$76.14	$113.18	$182.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.38 / $55.39 / $55.39	Professional		$46.38	$55.39	$55.39