Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.65 / $119.54 / $344.45	Facility		$89.65	$119.54	$344.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.91 / $99.55 / $150.50	Professional		$77.91	$99.55	$150.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.36 / $77.69 / $130.91	Professional		$71.36	$77.69	$130.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $45.76 / $133.18 / $479.89	Facility		$45.76	$133.18	$479.89
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $93.90 / $140.91 / $830.33	Professional		$93.90	$140.91	$830.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.11 / $119.52 / $241.28	Professional		$76.11	$119.52	$241.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $86.52 / $115.93 / $218.79	Facility		$86.52	$115.93	$218.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $86.52 / $115.18 / $199.17	Professional		$86.52	$115.18	$199.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.27 / $131.92 / $252.89	Professional		$31.27	$131.92	$252.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $120.66 / $195.85 / $205.69	Facility		$120.66	$195.85	$205.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $133.18 / $133.18 / $133.18	Facility		$133.18	$133.18	$133.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.58 / $215.97 / $267.75	Professional		$126.58	$215.97	$267.75
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $45.76 / $101.97 / $543.76	Facility		$45.76	$101.97	$543.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $94.76 / $118.17 / $150.50	Professional		$94.76	$118.17	$150.50
United Facility/Professional Professional Modifier Low / Median / High Price $91.77 / $140.44 / $282.83	Professional		$91.77	$140.44	$282.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.79 / $103.59 / $109.09	Professional		$87.79	$103.59	$109.09