Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.00 / $141.47 / $264.20	Facility		$91.00	$141.47	$264.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.01 / $91.00 / $419.00	Professional		$72.01	$91.00	$419.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.67 / $68.67 / $145.44	Professional		$68.67	$68.67	$145.44
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $102.38 / $187.93 / $333.03	Facility		$102.38	$187.93	$333.03
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $104.41 / $188.00 / $627.83	Professional		$104.41	$188.00	$627.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.20 / $142.28 / $232.87	Professional		$86.20	$142.28	$232.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $77.81 / $159.79 / $203.39	Facility		$77.81	$159.79	$203.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.81 / $161.12 / $207.70	Professional		$77.81	$161.12	$207.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.62 / $65.14 / $147.48	Professional		$12.62	$65.14	$147.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $113.19 / $145.58 / $155.72	Facility		$113.19	$145.58	$155.72
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $43.82 / $43.82 / $43.82	Professional		$43.82	$43.82	$43.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $34.44 / $101.91 / $102.38	Facility		$34.44	$101.91	$102.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.47 / $170.44 / $209.02	Professional		$115.47	$170.44	$209.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $39.27 / $39.27 / $187.93	Facility		$39.27	$39.27	$187.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $104.41 / $148.31 / $200.30	Professional		$104.41	$148.31	$200.30
United Facility/Professional Professional Modifier Low / Median / High Price $80.12 / $88.13 / $211.84	Professional		$80.12	$88.13	$211.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $80.79 / $80.79 / $80.79	Professional		$80.79	$80.79	$80.79