Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.64 / $91.92 / $148.59	Professional		$79.64	$91.92	$148.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $164.42 / $164.42 / $167.99	Professional		$164.42	$164.42	$167.99
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $911.54 / $911.54	Facility		$100.00	$911.54	$911.54
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $20.04 / $139.97 / $216.80	Professional		$20.04	$139.97	$216.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.12 / $129.12 / $131.69	Facility		$129.12	$129.12	$131.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.75 / $129.12 / $202.50	Professional		$109.75	$129.12	$202.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $166.70 / $166.70 / $166.70	Facility		$166.70	$166.70	$166.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $166.70 / $166.70 / $166.70	Professional		$166.70	$166.70	$166.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $186.66 / $205.32	Professional		$75.00	$186.66	$205.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $238.89 / $267.30 / $325.62	Facility		$238.89	$267.30	$325.62
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $267.30 / $325.62 / $325.62	Professional		$267.30	$325.62	$325.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $16.13 / $16.13 / $16.13	Facility		$16.13	$16.13	$16.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.75 / $137.53 / $186.07	Professional		$13.75	$137.53	$186.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $16.46 / $16.46 / $20.04	Professional		$16.46	$16.46	$20.04
United Facility/Professional Professional Modifier Low / Median / High Price $80.33 / $111.88 / $140.58	Professional		$80.33	$111.88	$140.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $173.55 / $173.55 / $173.55	Professional		$173.55	$173.55	$173.55