Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.20 / $140.37 / $272.45	Facility		$122.20	$140.37	$272.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.80 / $131.75 / $246.47	Professional		$94.80	$131.75	$246.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.30 / $96.45 / $143.96	Professional		$94.30	$96.45	$143.96
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $123.16 / $157.65 / $295.58	Facility		$123.16	$157.65	$295.58
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $103.00 / $250.09 / $699.89	Professional		$103.00	$250.09	$699.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.20 / $194.34 / $295.62	Professional		$102.20	$194.34	$295.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $101.69 / $186.87 / $271.18	Facility		$101.69	$186.87	$271.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $101.69 / $213.78 / $273.54	Professional		$101.69	$213.78	$273.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $66.29 / $104.35 / $201.72	Professional		$66.29	$104.35	$201.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $159.74 / $195.09 / $221.10	Facility		$159.74	$195.09	$221.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $123.16 / $147.80 / $280.81	Facility		$123.16	$147.80	$280.81
United Facility/Professional Professional Modifier Low / Median / High Price $120.92 / $164.49 / $292.47	Professional		$120.92	$164.49	$292.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $81.99 / $81.99 / $104.21	Professional		$81.99	$81.99	$104.21