Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.46 / $143.63 / $265.48	Facility		$109.46	$143.63	$265.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.87 / $124.60 / $265.48	Professional		$78.87	$124.60	$265.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.62 / $127.54 / $158.60	Professional		$78.62	$127.54	$158.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $106.64 / $157.18 / $373.71	Facility		$106.64	$157.18	$373.71
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $106.61 / $178.25 / $613.55	Professional		$106.61	$178.25	$613.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.54 / $168.91 / $243.91	Professional		$89.54	$168.91	$243.91
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $88.66 / $165.01 / $218.87	Facility		$88.66	$165.01	$218.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.48 / $177.19 / $231.12	Professional		$89.48	$177.19	$231.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.08 / $157.43 / $283.92	Professional		$29.08	$157.43	$283.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $135.09 / $163.59 / $194.30	Facility		$135.09	$163.59	$194.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $106.64 / $106.64 / $131.82	Facility		$106.64	$106.64	$131.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.86 / $187.53 / $230.58	Professional		$123.86	$187.53	$230.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $133.28 / $162.66 / $221.71	Professional		$133.28	$162.66	$221.71
United Facility/Professional Professional Modifier Low / Median / High Price $106.89 / $141.12 / $249.91	Professional		$106.89	$141.12	$249.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $67.91 / $67.91 / $85.73	Professional		$67.91	$67.91	$85.73