Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.19 / $73.06 / $115.90	Facility		$32.19	$73.06	$115.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.53 / $32.19 / $55.69	Professional		$14.53	$32.19	$55.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $37.15 / $49.53	Professional		$37.15	$37.15	$49.53
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $42.10 / $99.62 / $230.54	Facility		$42.10	$99.62	$230.54
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $33.81 / $44.10 / $314.95	Professional		$33.81	$44.10	$314.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.97 / $35.00 / $35.00	Facility		$29.97	$35.00	$35.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.55 / $25.55 / $35.00	Professional		$25.55	$25.55	$35.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $27.75 / $49.53 / $125.62	Facility		$27.75	$49.53	$125.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.78 / $49.53 / $92.68	Professional		$27.78	$49.53	$92.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.18 / $37.97 / $41.77	Professional		$34.18	$37.97	$41.77
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $39.34 / $45.16 / $49.53	Facility		$39.34	$45.16	$49.53
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $44.58 / $49.53 / $49.53	Professional		$44.58	$49.53	$49.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $32.13 / $55.63 / $96.74	Facility		$32.13	$55.63	$96.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.13 / $55.00 / $69.98	Professional		$32.13	$55.00	$69.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $47.14 / $48.37 / $48.37	Facility		$47.14	$48.37	$48.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $39.36 / $42.10 / $54.48	Professional		$39.36	$42.10	$54.48
United Facility/Professional Professional Modifier Low / Median / High Price $20.84 / $32.93 / $41.71	Professional		$20.84	$32.93	$41.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.04 / $28.04 / $42.10	Professional		$28.04	$28.04	$42.10