Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.46 / $154.07 / $267.87	Facility		$103.46	$154.07	$267.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.76 / $118.58 / $331.81	Professional		$83.76	$118.58	$331.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.08 / $183.28 / $231.52	Professional		$112.08	$183.28	$231.52
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $134.09 / $220.54 / $704.00	Facility		$134.09	$220.54	$704.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $130.19 / $233.06 / $707.45	Professional		$130.19	$233.06	$707.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.53 / $202.55 / $331.32	Professional		$102.53	$202.55	$331.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $91.45 / $180.38 / $259.74	Facility		$91.45	$180.38	$259.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.76 / $198.38 / $266.05	Professional		$91.76	$198.38	$266.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.08 / $157.89 / $283.92	Professional		$29.08	$157.89	$283.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $142.93 / $196.98 / $235.84	Facility		$142.93	$196.98	$235.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.09 / $134.09 / $152.59	Facility		$134.09	$134.09	$152.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.58 / $258.17 / $319.30	Professional		$165.58	$258.17	$319.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $135.57 / $216.30 / $292.16	Professional		$135.57	$216.30	$292.16
United Facility/Professional Professional Modifier Low / Median / High Price $111.41 / $147.00 / $295.31	Professional		$111.41	$147.00	$295.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.18 / $97.18 / $123.15	Professional		$97.18	$97.18	$123.15