Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $114.18 / $185.04	Professional		$95.90	$114.18	$185.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $197.93 / $197.93 / $197.93	Professional		$197.93	$197.93	$197.93
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,102.70 / $1,102.70	Facility		$100.00	$1,102.70	$1,102.70
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $24.08 / $173.21 / $264.30	Professional		$24.08	$173.21	$264.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.98 / $123.98 / $126.46	Facility		$123.98	$123.98	$126.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.38 / $123.98 / $167.40	Professional		$105.38	$123.98	$167.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $210.20 / $210.20 / $210.20	Facility		$210.20	$210.20	$210.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $210.20 / $210.20 / $210.20	Professional		$210.20	$210.20	$210.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $224.71 / $247.18	Professional		$75.00	$224.71	$247.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $287.60 / $322.85 / $393.29	Facility		$287.60	$322.85	$393.29
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $322.85 / $393.29 / $393.29	Professional		$322.85	$393.29	$393.29
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $20.03 / $20.03 / $20.03	Facility		$20.03	$20.03	$20.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.35 / $197.98 / $234.71	Professional		$17.35	$197.98	$234.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $19.78 / $19.78 / $24.08	Professional		$19.78	$19.78	$24.08
United Facility/Professional Professional Modifier Low / Median / High Price $97.01 / $130.34 / $161.68	Professional		$97.01	$130.34	$161.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93