Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $116.10 / $172.07 / $251.65	Facility		$116.10	$172.07	$251.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.62 / $95.36 / $228.81	Professional		$52.62	$95.36	$228.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.60 / $118.09 / $201.82	Professional		$96.60	$118.09	$201.82
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $146.81 / $299.75 / $299.75	Facility		$146.81	$299.75	$299.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $96.48 / $178.16 / $618.82	Professional		$96.48	$178.16	$618.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.61 / $140.74 / $267.24	Professional		$75.61	$140.74	$267.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $64.16 / $134.19 / $227.61	Facility		$64.16	$134.19	$227.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.79 / $133.15 / $227.61	Professional		$64.79	$133.15	$227.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.17 / $103.58 / $216.00	Professional		$62.17	$103.58	$216.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $122.50 / $185.21 / $196.98	Facility		$122.50	$185.21	$196.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.37 / $131.37 / $131.37	Facility		$131.37	$131.37	$131.37
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.72 / $169.12 / $255.81	Professional		$107.72	$169.12	$255.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $122.34 / $146.81 / $204.26	Facility		$122.34	$146.81	$204.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $98.51 / $148.40 / $223.29	Professional		$98.51	$148.40	$223.29
United Facility/Professional Professional Modifier Low / Median / High Price $97.76 / $161.30 / $284.26	Professional		$97.76	$161.30	$284.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.45 / $81.16 / $107.35	Professional		$69.45	$81.16	$107.35