Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.22 / $216.79 / $332.80	Facility		$122.22	$216.79	$332.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.84 / $134.19 / $307.04	Professional		$78.84	$134.19	$307.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $88.40 / $131.85 / $196.46	Professional		$88.40	$131.85	$196.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $202.34 / $420.83 / $420.83	Facility		$202.34	$420.83	$420.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $131.19 / $235.09 / $785.23	Professional		$131.19	$235.09	$785.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.99 / $191.95 / $336.33	Professional		$100.99	$191.95	$336.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $88.96 / $183.10 / $285.20	Facility		$88.96	$183.10	$285.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.59 / $181.06 / $285.20	Professional		$89.59	$181.06	$285.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.23 / $90.68 / $372.66	Professional		$37.23	$90.68	$372.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $172.00 / $237.18 / $248.57	Facility		$172.00	$237.18	$248.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $167.16 / $167.16 / $167.16	Facility		$167.16	$167.16	$167.16
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.27 / $224.94 / $322.81	Professional		$152.27	$224.94	$322.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $154.38 / $185.25 / $259.83	Facility		$154.38	$185.25	$259.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $136.94 / $197.09 / $287.14	Professional		$136.94	$197.09	$287.14
United Facility/Professional Professional Modifier Low / Median / High Price $126.00 / $200.49 / $353.38	Professional		$126.00	$200.49	$353.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.29 / $103.25 / $135.16	Professional		$97.29	$103.25	$135.16