Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.04 / $181.72 / $326.55	Facility		$124.04	$181.72	$326.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.80 / $110.94 / $254.56	Professional		$66.80	$110.94	$254.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.07 / $151.07 / $155.83	Professional		$151.07	$151.07	$155.83
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $126.84 / $436.62 / $987.53	Facility		$126.84	$436.62	$987.53
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $113.40 / $190.87 / $723.76	Professional		$113.40	$190.87	$723.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.71 / $151.71 / $151.71	Facility		$151.71	$151.71	$151.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.84 / $145.31 / $270.89	Professional		$80.84	$145.31	$270.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $82.00 / $138.77 / $236.07	Facility		$82.00	$138.77	$236.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $82.00 / $138.77 / $231.12	Professional		$82.00	$138.77	$231.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.16 / $151.02 / $269.28	Professional		$27.16	$151.02	$269.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $118.19 / $179.56 / $197.65	Facility		$118.19	$179.56	$197.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.16 / $126.84 / $134.82	Facility		$44.16	$126.84	$134.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.38 / $167.03 / $241.60	Professional		$112.38	$167.03	$241.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $289.56 / $446.53 / $854.16	Facility		$289.56	$446.53	$854.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $100.80 / $155.41 / $229.02	Professional		$100.80	$155.41	$229.02
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $546.00 / $5,793.00	Facility		$157.00	$546.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $113.36 / $152.76 / $275.49	Professional		$113.36	$152.76	$275.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $74.81 / $83.09 / $111.90	Professional		$74.81	$83.09	$111.90