Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.31 / $120.92 / $154.53	Facility		$105.31	$120.92	$154.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.20 / $94.95 / $158.85	Professional		$76.20	$94.95	$158.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.16 / $88.17 / $147.01	Professional		$80.16	$88.17	$147.01
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $85.61 / $405.71 / $405.71	Facility		$85.61	$405.71	$405.71
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $85.05 / $131.91 / $718.65	Professional		$85.05	$131.91	$718.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.00 / $123.26 / $262.14	Professional		$73.00	$123.26	$262.14
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $77.28 / $103.55 / $199.92	Facility		$77.28	$103.55	$199.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.28 / $103.55 / $181.55	Professional		$77.28	$103.55	$181.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.86 / $144.88 / $260.78	Professional		$28.86	$144.88	$260.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $119.39 / $185.59 / $198.99	Facility		$119.39	$185.59	$198.99
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $127.75 / $127.75 / $127.75	Facility		$127.75	$127.75	$127.75
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.91 / $189.49 / $247.08	Professional		$127.91	$189.49	$247.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $198.15 / $198.15 / $304.01	Facility		$198.15	$198.15	$304.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $85.05 / $112.37 / $144.04	Professional		$85.05	$112.37	$144.04
United Facility/Professional Professional Modifier Low / Median / High Price $83.27 / $127.42 / $265.93	Professional		$83.27	$127.42	$265.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $84.48 / $91.88 / $106.88	Professional		$84.48	$91.88	$106.88