Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.17 / $87.97 / $168.36	Facility		$68.17	$87.97	$168.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.59 / $61.47 / $90.90	Professional		$47.59	$61.47	$90.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $138.00 / $138.00	Professional		$40.65	$138.00	$138.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $90.60 / $284.58 / $284.58	Facility		$90.60	$284.58	$284.58
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $63.89 / $111.40 / $219.04	Professional		$63.89	$111.40	$219.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.91 / $111.49 / $177.39	Professional		$54.91	$111.49	$177.39
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $54.75 / $72.45 / $142.57	Facility		$54.75	$72.45	$142.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.75 / $72.78 / $135.71	Professional		$54.75	$72.78	$135.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.67 / $53.90 / $90.65	Professional		$37.67	$53.90	$90.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $93.47 / $127.07 / $132.66	Facility		$93.47	$127.07	$132.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $90.60 / $90.60 / $90.60	Facility		$90.60	$90.60	$90.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.40 / $139.79 / $176.21	Professional		$92.40	$139.79	$176.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $131.16 / $131.16 / $131.16	Facility		$131.16	$131.16	$131.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $87.48 / $110.78 / $157.91	Professional		$87.48	$110.78	$157.91
United Facility/Professional Professional Modifier Low / Median / High Price $56.75 / $88.36 / $186.48	Professional		$56.75	$88.36	$186.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.11 / $64.01 / $69.06	Professional		$54.11	$64.01	$69.06