Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.02 / $127.37 / $203.27	Facility		$81.02	$127.37	$203.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.95 / $88.96 / $260.00	Professional		$63.95	$88.96	$260.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.68 / $118.35 / $139.24	Professional		$74.68	$118.35	$139.24
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $93.20 / $133.85 / $323.95	Facility		$93.20	$133.85	$323.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $86.02 / $146.31 / $649.20	Professional		$86.02	$146.31	$649.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.42 / $133.65 / $214.27	Professional		$70.42	$133.65	$214.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $62.58 / $121.90 / $175.43	Facility		$62.58	$121.90	$175.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.33 / $142.57 / $175.72	Professional		$66.33	$142.57	$175.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.08 / $157.22 / $283.92	Professional		$29.08	$157.22	$283.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $105.62 / $140.47 / $146.06	Facility		$105.62	$140.47	$146.06
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.20 / $93.20 / $97.85	Facility		$93.20	$93.20	$97.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.92 / $163.59 / $195.03	Professional		$104.92	$163.59	$195.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $98.93 / $137.66 / $188.51	Professional		$98.93	$137.66	$188.51
United Facility/Professional Professional Modifier Low / Median / High Price $69.22 / $105.50 / $207.59	Professional		$69.22	$105.50	$207.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $59.08 / $59.08 / $74.68	Professional		$59.08	$59.08	$74.68