Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.97 / $162.26 / $184.93	Facility		$129.97	$162.26	$184.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.54 / $124.60 / $179.62	Professional		$93.54	$124.60	$179.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.57 / $126.69 / $253.23	Professional		$94.57	$126.69	$253.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $173.50 / $481.38 / $481.38	Facility		$173.50	$481.38	$481.38
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $115.61 / $182.75 / $860.48	Professional		$115.61	$182.75	$860.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.00 / $139.00 / $276.45	Professional		$106.00	$139.00	$276.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $95.12 / $137.19 / $263.66	Facility		$95.12	$137.19	$263.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.12 / $130.47 / $233.61	Professional		$95.12	$130.47	$233.61
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 $151.96 / $253.26 / $257.95	Facility		$151.96	$253.26	$257.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.50 / $173.50 / $173.50	Facility		$173.50	$173.50	$173.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.82 / $243.04 / $332.24	Professional		$160.82	$243.04	$332.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,191.47 / $1,191.47 / $1,827.98	Facility		$1,191.47	$1,191.47	$1,827.98
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $126.21 / $160.22 / $221.80	Professional		$126.21	$160.22	$221.80
United Facility/Professional Professional Modifier Low / Median / High Price $136.63 / $189.21 / $364.81	Professional		$136.63	$189.21	$364.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $103.48 / $109.65 / $136.88	Professional		$103.48	$109.65	$136.88