Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.93 / $133.21 / $189.78	Facility		$115.93	$133.21	$189.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.67 / $113.33 / $155.06	Professional		$90.67	$113.33	$155.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.91 / $118.39 / $219.02	Professional		$73.91	$118.39	$219.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $159.00 / $496.55 / $496.55	Facility		$159.00	$496.55	$496.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $113.76 / $172.63 / $896.18	Professional		$113.76	$172.63	$896.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.00 / $126.00 / $263.27	Professional		$97.00	$126.00	$263.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $96.04 / $127.10 / $254.52	Facility		$96.04	$127.10	$254.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $92.40 / $123.81 / $221.56	Professional		$92.40	$123.81	$221.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.26 / $193.39 / $346.76	Professional		$38.26	$193.39	$346.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $143.53 / $231.82 / $241.20	Facility		$143.53	$231.82	$241.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $159.00 / $159.00 / $159.00	Facility		$159.00	$159.00	$159.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.94 / $240.20 / $307.14	Professional		$157.94	$240.20	$307.14
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $697.74 / $697.74 / $1,070.49	Facility		$697.74	$697.74	$1,070.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $130.63 / $156.34 / $213.95	Professional		$130.63	$156.34	$213.95
United Facility/Professional Professional Modifier Low / Median / High Price $124.53 / $169.00 / $325.49	Professional		$124.53	$169.00	$325.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $100.21 / $113.24 / $127.05	Professional		$100.21	$113.24	$127.05