Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.98 / $227.23 / $944.36	Facility		$86.98	$227.23	$944.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.93 / $90.04 / $561.60	Professional		$84.93	$90.04	$561.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $160.40 / $179.84 / $308.62	Professional		$160.40	$179.84	$308.62
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $97.21 / $167.76 / $717.30	Facility		$97.21	$167.76	$717.30
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $97.21 / $97.21 / $717.30	Professional		$97.21	$97.21	$717.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.98 / $86.98 / $173.96	Facility		$86.98	$86.98	$173.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.98 / $86.98 / $86.98	Professional		$86.98	$86.98	$86.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $108.50 / $254.24 / $363.58	Facility		$108.50	$254.24	$363.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $108.50 / $254.87 / $377.48	Professional		$108.50	$254.87	$377.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $106.93	Professional		$75.00	$75.00	$106.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $97.21 / $97.21 / $322.27	Facility		$97.21	$97.21	$322.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.21 / $97.21 / $97.21	Facility		$97.21	$97.21	$97.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.21 / $97.21 / $97.21	Professional		$97.21	$97.21	$97.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $97.21 / $97.21 / $97.21	Facility		$97.21	$97.21	$97.21
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $92.35 / $97.21 / $97.21	Professional		$92.35	$97.21	$97.21
United Facility/Professional Facility Modifier Low / Median / High Price $85.27 / $85.27 / $85.27	Facility		$85.27	$85.27	$85.27
United Facility/Professional Professional Modifier Low / Median / High Price $85.27 / $85.27 / $102.32	Professional		$85.27	$85.27	$102.32