Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.48 / $164.64 / $398.00	Facility		$123.48	$164.64	$398.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.84 / $160.88 / $258.54	Professional		$123.84	$160.88	$258.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $161.32 / $241.97 / $356.79	Professional		$161.32	$241.97	$356.79
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $262.29 / $765.98 / $765.98	Facility		$262.29	$765.98	$765.98
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $164.29 / $268.88 / $1,394.70	Professional		$164.29	$268.88	$1,394.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.49 / $199.57 / $476.64	Professional		$100.49	$199.57	$476.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $110.76 / $150.08 / $291.01	Facility		$110.76	$150.08	$291.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $113.89 / $154.59 / $282.99	Professional		$113.89	$154.59	$282.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.52 / $231.13 / $425.84	Professional		$48.52	$231.13	$425.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $209.48 / $319.36 / $389.94	Facility		$209.48	$319.36	$389.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $262.29 / $262.29 / $262.29	Facility		$262.29	$262.29	$262.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.89 / $381.56 / $501.82	Professional		$229.89	$381.56	$501.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $354.42 / $354.42 / $543.76	Facility		$354.42	$354.42	$543.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $164.29 / $234.70 / $386.57	Professional		$164.29	$234.70	$386.57
United Facility/Professional Professional Modifier Low / Median / High Price $146.00 / $231.07 / $445.88	Professional		$146.00	$231.07	$445.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $160.38 / $173.96 / $203.56	Professional		$160.38	$173.96	$203.56