Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.12 / $195.75 / $323.00	Facility		$47.12	$195.75	$323.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.31 / $162.56 / $321.45	Professional		$117.31	$162.56	$321.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.50 / $159.90 / $219.00	Professional		$52.50	$159.90	$219.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $139.81 / $223.70 / $719.08	Facility		$139.81	$223.70	$719.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $186.54 / $375.22 / $1,368.98	Professional		$186.54	$375.22	$1,368.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $262.77 / $429.05 / $559.12	Facility		$262.77	$429.05	$559.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.26 / $292.12 / $516.70	Professional		$142.26	$292.12	$516.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $165.23 / $334.80 / $452.27	Facility		$165.23	$334.80	$452.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.23 / $338.01 / $452.27	Professional		$165.23	$338.01	$452.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $209.44 / $313.35 / $318.92	Facility		$209.44	$313.35	$318.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $215.18 / $215.18 / $217.53	Facility		$215.18	$215.18	$217.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $241.96 / $368.42 / $451.15	Professional		$241.96	$368.42	$451.15
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $139.81 / $167.78 / $241.08	Facility		$139.81	$167.78	$241.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $219.45 / $326.06 / $442.67	Professional		$219.45	$326.06	$442.67
United Facility/Professional Professional Modifier Low / Median / High Price $159.03 / $200.79 / $450.31	Professional		$159.03	$200.79	$450.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $159.88 / $159.88 / $159.88	Professional		$159.88	$159.88	$159.88