Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.85 / $187.51 / $294.93	Facility		$62.85	$187.51	$294.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.42 / $108.04 / $220.39	Professional		$73.42	$108.04	$220.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $235.84 / $235.84 / $235.84	Professional		$235.84	$235.84	$235.84
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $132.41 / $173.34 / $338.40	Facility		$132.41	$173.34	$338.40
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $161.69 / $289.38 / $1,038.75	Professional		$161.69	$289.38	$1,038.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.06 / $189.52 / $367.62	Professional		$107.06	$189.52	$367.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $101.50 / $171.88 / $310.41	Facility		$101.50	$171.88	$310.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.39 / $176.58 / $329.08	Professional		$103.39	$176.58	$329.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.26 / $150.94 / $272.93	Professional		$27.26	$150.94	$272.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $98.49 / $193.03 / $238.52	Facility		$98.49	$193.03	$238.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.55 / $158.55 / $162.69	Facility		$158.55	$158.55	$162.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.69 / $268.60 / $322.93	Professional		$162.69	$268.60	$322.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $112.40 / $173.34 / $331.58	Facility		$112.40	$173.34	$331.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $137.44 / $218.76 / $308.32	Professional		$137.44	$218.76	$308.32
United Facility/Professional Facility Modifier Low / Median / High Price $168.84 / $220.31 / $346.24	Facility		$168.84	$220.31	$346.24
United Facility/Professional Professional Modifier Low / Median / High Price $96.48 / $192.38 / $391.93	Professional		$96.48	$192.38	$391.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $138.28 / $138.28 / $138.28	Professional		$138.28	$138.28	$138.28