Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.44 / $123.58 / $129.02	Facility		$54.44	$123.58	$129.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $54.44 / $123.58	Professional		$37.20	$54.44	$123.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.59 / $72.59 / $72.59	Professional		$72.59	$72.59	$72.59
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $70.64 / $166.93 / $330.88	Facility		$70.64	$166.93	$330.88
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $46.50 / $68.56 / $527.66	Professional		$46.50	$68.56	$527.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.99 / $48.99 / $48.99	Facility		$48.99	$48.99	$48.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.76 / $35.76 / $48.99	Professional		$35.76	$35.76	$48.99
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $38.22 / $76.64 / $173.43	Facility		$38.22	$76.64	$173.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.26 / $76.64 / $128.26	Professional		$38.26	$76.64	$128.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.66 / $61.85 / $68.03	Professional		$55.66	$61.85	$68.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $64.04 / $72.59 / $80.67	Facility		$64.04	$72.59	$80.67
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $66.43 / $80.67 / $80.67	Professional		$66.43	$80.67	$80.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $70.64 / $90.60 / $157.56	Facility		$70.64	$90.60	$157.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.95 / $66.95 / $66.95	Professional		$66.95	$66.95	$66.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $76.78 / $78.78 / $78.78	Facility		$76.78	$78.78	$78.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $64.09 / $68.56 / $88.74	Professional		$64.09	$68.56	$88.74
United Facility/Professional Professional Modifier Low / Median / High Price $27.91 / $32.56 / $57.59	Professional		$27.91	$32.56	$57.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.31 / $33.31 / $36.36	Professional		$33.31	$33.31	$36.36