Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.21 / $50.38 / $115.46	Professional		$42.21	$50.38	$115.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.16 / $89.16 / $89.16	Professional		$89.16	$89.16	$89.16
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $88.41 / $473.38 / $473.38	Facility		$88.41	$473.38	$473.38
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $57.89 / $80.17 / $108.50	Professional		$57.89	$80.17	$108.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.95 / $65.95 / $87.12	Facility		$65.95	$65.95	$87.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.07 / $65.95 / $87.48	Professional		$56.07	$65.95	$87.48
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $92.84 / $92.84 / $92.84	Facility		$92.84	$92.84	$92.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $92.84 / $92.84 / $92.84	Professional		$92.84	$92.84	$92.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $98.93 / $108.82	Professional		$75.00	$98.93	$108.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $92.84 / $97.42 / $123.93	Facility		$92.84	$97.42	$123.93
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $88.20 / $97.42 / $123.93	Professional		$88.20	$97.42	$123.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $8.85 / $88.41 / $103.66	Facility		$8.85	$88.41	$103.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.67 / $90.14 / $107.16	Professional		$7.67	$90.14	$107.16
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $90.14 / $90.14 / $90.14	Facility		$90.14	$90.14	$90.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $8.73 / $8.73 / $10.63	Professional		$8.73	$8.73	$10.63
United Facility/Professional Professional Modifier Low / Median / High Price $49.87 / $58.70 / $95.83	Professional		$49.87	$58.70	$95.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $80.17 / $80.17 / $92.36	Professional		$80.17	$80.17	$92.36