Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.68 / $148.90 / $290.47	Facility		$111.68	$148.90	$290.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.52 / $132.43 / $177.44	Professional		$102.52	$132.43	$177.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.53 / $132.25 / $224.97	Professional		$107.53	$132.25	$224.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $127.05 / $610.08 / $610.08	Facility		$127.05	$610.08	$610.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $119.34 / $188.89 / $1,056.08	Professional		$119.34	$188.89	$1,056.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.00 / $203.50 / $347.58	Professional		$111.00	$203.50	$347.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $108.36 / $145.18 / $292.63	Facility		$108.36	$145.18	$292.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.80 / $144.44 / $261.52	Professional		$107.80	$144.44	$261.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.26 / $193.59 / $348.54	Professional		$38.26	$193.59	$348.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $176.88 / $249.91 / $294.80	Facility		$176.88	$249.91	$294.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $188.90 / $188.90 / $188.90	Facility		$188.90	$188.90	$188.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.80 / $280.77 / $368.41	Professional		$173.80	$280.77	$368.41
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $127.05 / $127.05 / $543.76	Facility		$127.05	$127.05	$543.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $120.78 / $166.76 / $213.46	Professional		$120.78	$166.76	$213.46
United Facility/Professional Professional Modifier Low / Median / High Price $102.25 / $162.37 / $350.82	Professional		$102.25	$162.37	$350.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $126.71 / $138.21 / $160.31	Professional		$126.71	$138.21	$160.31