Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.04 / $279.32 / $989.07	Facility		$105.04	$279.32	$989.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.04 / $115.23 / $242.11	Professional		$91.04	$115.23	$242.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $277.05 / $277.05 / $277.05	Professional		$277.05	$277.05	$277.05
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $141.34 / $496.55 / $496.55	Facility		$141.34	$496.55	$496.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $144.13 / $252.52 / $910.05	Professional		$144.13	$252.52	$910.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.02 / $206.47 / $332.72	Professional		$130.02	$206.47	$332.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $96.10 / $197.60 / $277.97	Facility		$96.10	$197.60	$277.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.12 / $215.65 / $277.97	Professional		$100.12	$215.65	$277.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.42 / $156.63 / $261.47	Professional		$26.42	$156.63	$261.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $142.59 / $194.30 / $215.74	Facility		$142.59	$194.30	$215.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.34 / $141.34 / $147.15	Facility		$141.34	$141.34	$147.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.87 / $245.46 / $292.08	Professional		$163.87	$245.46	$292.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $144.13 / $144.13 / $144.13	Facility		$144.13	$144.13	$144.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $144.13 / $220.57 / $289.22	Professional		$144.13	$220.57	$289.22
United Facility/Professional Professional Modifier Low / Median / High Price $120.38 / $136.24 / $276.32	Professional		$120.38	$136.24	$276.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $117.18 / $117.18 / $117.18	Professional		$117.18	$117.18	$117.18