Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.00 / $182.00 / $991.88	Facility		$81.00	$182.00	$991.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.99 / $48.20 / $114.23	Professional		$39.99	$48.20	$114.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.27 / $64.27 / $64.27	Professional		$64.27	$64.27	$64.27
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $62.53 / $169.23 / $295.50	Facility		$62.53	$169.23	$295.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $42.58 / $60.70 / $534.87	Professional		$42.58	$60.70	$534.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.15 / $39.15 / $39.15	Facility		$39.15	$39.15	$39.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.59 / $28.59 / $39.15	Professional		$28.59	$28.59	$39.15
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $33.67 / $67.84 / $153.75	Facility		$33.67	$67.84	$153.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.70 / $67.84 / $114.19	Professional		$33.70	$67.84	$114.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.26 / $54.74 / $60.21	Professional		$49.26	$54.74	$60.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $56.69 / $69.73 / $71.41	Facility		$56.69	$69.73	$71.41
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $64.27 / $71.41 / $71.41	Professional		$64.27	$71.41	$71.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.53 / $80.20 / $139.47	Facility		$62.53	$80.20	$139.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.28 / $59.28 / $59.28	Professional		$59.28	$59.28	$59.28
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $67.97 / $69.73 / $69.73	Facility		$67.97	$69.73	$69.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $56.73 / $60.70 / $78.55	Professional		$56.73	$60.70	$78.55
United Facility/Professional Facility Modifier Low / Median / High Price $51.23 / $51.23 / $51.23	Facility		$51.23	$51.23	$51.23
United Facility/Professional Professional Modifier Low / Median / High Price $24.71 / $26.77 / $50.98	Professional		$24.71	$26.77	$50.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.44 / $22.44 / $32.25	Professional		$22.44	$22.44	$32.25