Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $135.40 / $180.53 / $350.54	Facility		$135.40	$180.53	$350.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.86 / $159.00 / $363.66	Professional		$114.86	$159.00	$363.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $126.06 / $223.77 / $254.97	Professional		$126.06	$223.77	$254.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $168.20 / $249.00 / $587.34	Facility		$168.20	$249.00	$587.34
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $153.10 / $268.50 / $827.90	Professional		$153.10	$268.50	$827.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.51 / $242.60 / $384.90	Professional		$129.51	$242.60	$384.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $119.66 / $224.40 / $312.29	Facility		$119.66	$224.40	$312.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.77 / $253.99 / $319.89	Professional		$120.77	$253.99	$319.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.73 / $209.60 / $379.82	Professional		$38.73	$209.60	$379.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $190.39 / $253.70 / $261.30	Facility		$190.39	$253.70	$261.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $168.20 / $168.20 / $177.12	Facility		$168.20	$168.20	$177.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $187.88 / $292.95 / $351.95	Professional		$187.88	$292.95	$351.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $179.08 / $248.44 / $343.55	Professional		$179.08	$248.44	$343.55
United Facility/Professional Professional Modifier Low / Median / High Price $144.44 / $190.61 / $371.73	Professional		$144.44	$190.61	$371.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.11 / $107.11 / $135.62	Professional		$107.11	$107.11	$135.62