Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.19 / $168.64 / $828.97	Facility		$49.19	$168.64	$828.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $45.16 / $304.25	Professional		$40.65	$45.16	$304.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.38 / $63.38 / $78.73	Professional		$63.38	$63.38	$78.73
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $40.65 / $192.85 / $192.85	Facility		$40.65	$192.85	$192.85
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $41.20 / $1,627.92	Professional		$40.65	$41.20	$1,627.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.35 / $38.35 / $83.76	Facility		$38.35	$38.35	$83.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $49.86	Professional		$40.65	$40.65	$49.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $40.65 / $57.71 / $126.58	Facility		$40.65	$57.71	$126.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $66.67 / $126.58	Professional		$40.65	$66.67	$126.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $75.00 / $75.00	Professional		$70.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $40.65 / $50.81 / $121.95	Facility		$40.65	$50.81	$121.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $183.21 / $183.21 / $183.21	Facility		$183.21	$183.21	$183.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.45 / $80.45 / $183.21	Professional		$76.45	$80.45	$183.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $40.65 / $40.65 / $40.65	Facility		$40.65	$40.65	$40.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $40.65 / $42.28	Professional		$38.61	$40.65	$42.28
United Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $44.72	Professional		$40.65	$40.65	$44.72