Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $299.74 / $299.74 / $299.74	Facility		$299.74	$299.74	$299.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $299.74 / $299.74 / $454.77	Professional		$299.74	$299.74	$454.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.20 / $177.20 / $177.20	Professional		$177.20	$177.20	$177.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $137.83 / $137.83 / $137.83	Facility		$137.83	$137.83	$137.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $84.60 / $94.00 / $158.19	Professional		$84.60	$94.00	$158.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $566.10 / $711.83	Professional		$49.95	$566.10	$711.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $468.74 / $468.74 / $468.74	Professional		$468.74	$468.74	$468.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $65.00	Professional		$50.00	$50.00	$65.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $76.38 / $127.30 / $127.30	Facility		$76.38	$127.30	$127.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $137.83 / $137.83 / $137.83	Facility		$137.83	$137.83	$137.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.83 / $137.83 / $513.00	Professional		$137.83	$137.83	$513.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $89.30 / $94.00 / $94.00	Professional		$89.30	$94.00	$94.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $95.88 / $95.88 / $95.88	Professional		$95.88	$95.88	$95.88