Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.39 / $18.98 / $130.59	Facility		$18.39	$18.98	$130.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.49 / $59.18 / $267.00	Professional		$38.49	$59.18	$267.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.80 / $92.63 / $130.00	Professional		$52.80	$92.63	$130.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $59.73 / $190.75 / $340.47	Facility		$59.73	$190.75	$340.47
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $48.46 / $64.59 / $612.72	Professional		$48.46	$64.59	$612.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.14 / $67.14 / $76.52	Facility		$67.14	$67.14	$76.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.01 / $49.01 / $76.52	Professional		$49.01	$49.01	$76.52
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $55.76 / $102.88 / $221.47	Facility		$55.76	$102.88	$221.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $55.76 / $104.58 / $193.79	Professional		$55.76	$104.58	$193.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $86.91 / $96.57 / $106.22	Professional		$86.91	$96.57	$106.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $61.52 / $80.06 / $99.99	Facility		$61.52	$80.06	$99.99
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $61.52 / $62.68 / $100.58	Professional		$61.52	$62.68	$100.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.37 / $72.37 / $136.06	Facility		$72.37	$72.37	$136.06
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.77 / $50.77 / $50.77	Professional		$50.77	$50.77	$50.77
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $59.73 / $59.73 / $74.77	Facility		$59.73	$59.73	$74.77
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $49.68 / $52.91 / $100.07	Professional		$49.68	$52.91	$100.07
United Facility/Professional Professional Modifier Low / Median / High Price $45.46 / $49.17 / $81.95	Professional		$45.46	$49.17	$81.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.04 / $52.04 / $59.85	Professional		$52.04	$52.04	$59.85