Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.99 / $112.99 / $112.99	Facility		$112.99	$112.99	$112.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.05 / $80.20 / $112.53	Professional		$64.05	$80.20	$112.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.50 / $28.50 / $28.50	Professional		$28.50	$28.50	$28.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $110.99 / $568.22 / $568.22	Facility		$110.99	$568.22	$568.22
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $69.76 / $122.50 / $705.08	Professional		$69.76	$122.50	$705.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $88.00 / $217.34	Professional		$55.00	$88.00	$217.34
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $69.16 / $92.67 / $182.25	Facility		$69.16	$92.67	$182.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.16 / $92.67 / $164.31	Professional		$69.16	$92.67	$164.31
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 $134.63 / $160.52 / $164.15	Facility		$134.63	$160.52	$164.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $110.99 / $110.99 / $110.99	Facility		$110.99	$110.99	$110.99
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.68 / $178.12 / $222.24	Professional		$101.68	$178.12	$222.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $163.10 / $163.10 / $163.10	Facility		$163.10	$163.10	$163.10
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $106.40 / $113.19 / $163.29	Professional		$106.40	$113.19	$163.29
United Facility/Professional Professional Modifier Low / Median / High Price $98.76 / $164.57 / $239.17	Professional		$98.76	$164.57	$239.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $77.92 / $77.92 / $77.92	Professional		$77.92	$77.92	$77.92