Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.66 / $183.69 / $268.61	Facility		$127.66	$183.69	$268.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.24 / $103.80 / $243.87	Professional		$61.24	$103.80	$243.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.70 / $128.80 / $182.37	Professional		$83.70	$128.80	$182.37
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $156.29 / $328.49 / $328.49	Facility		$156.29	$328.49	$328.49
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $105.27 / $192.15 / $657.47	Professional		$105.27	$192.15	$657.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.17 / $153.63 / $284.29	Professional		$83.17	$153.63	$284.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $70.98 / $147.43 / $242.36	Facility		$70.98	$147.43	$242.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.98 / $143.02 / $242.36	Professional		$70.98	$143.02	$242.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $68.31 / $113.65 / $222.00	Professional		$68.31	$113.65	$222.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $131.72 / $197.27 / $209.71	Facility		$131.72	$197.27	$209.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $139.52 / $139.52 / $139.52	Facility		$139.52	$139.52	$139.52
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.29 / $185.95 / $272.33	Professional		$118.29	$185.95	$272.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $130.24 / $156.29 / $217.26	Facility		$130.24	$156.29	$217.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $107.96 / $162.85 / $240.64	Professional		$107.96	$162.85	$240.64
United Facility/Professional Professional Modifier Low / Median / High Price $105.37 / $168.56 / $297.99	Professional		$105.37	$168.56	$297.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $86.41 / $113.98	Professional		$76.09	$86.41	$113.98