Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.81 / $175.32 / $220.20	Facility		$101.81	$175.32	$220.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.84 / $128.66 / $202.40	Professional		$71.84	$128.66	$202.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $125.83 / $251.67 / $273.87	Professional		$125.83	$251.67	$273.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $201.13 / $425.37 / $425.37	Facility		$201.13	$425.37	$425.37
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $110.31 / $215.83 / $578.25	Professional		$110.31	$215.83	$578.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.11 / $194.18 / $390.44	Professional		$104.11	$194.18	$390.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $78.53 / $140.80 / $255.32	Facility		$78.53	$140.80	$255.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $78.53 / $137.47 / $240.88	Professional		$78.53	$137.47	$240.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.03 / $198.63 / $347.65	Professional		$38.03	$198.63	$347.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $173.56 / $291.45 / $308.20	Facility		$173.56	$291.45	$308.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $201.13 / $201.13 / $201.13	Facility		$201.13	$201.13	$201.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.47 / $229.40 / $385.01	Professional		$140.47	$229.40	$385.01
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $198.15 / $198.15 / $304.01	Facility		$198.15	$198.15	$304.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $124.58 / $203.35 / $318.32	Professional		$124.58	$203.35	$318.32
United Facility/Professional Professional Modifier Low / Median / High Price $182.70 / $267.58 / $429.65	Professional		$182.70	$267.58	$429.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $91.53 / $123.96 / $164.88	Professional		$91.53	$123.96	$164.88