Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.57 / $85.25 / $196.52	Professional		$63.57	$85.25	$196.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.97 / $144.97 / $144.97	Professional		$144.97	$144.97	$144.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $14.96 / $348.41 / $782.36	Facility		$14.96	$348.41	$782.36
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $17.66 / $131.88 / $207.57	Professional		$17.66	$131.88	$207.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.90 / $115.90 / $144.38	Facility		$115.90	$115.90	$144.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.52 / $115.90 / $192.00	Professional		$98.52	$115.90	$192.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $158.37 / $158.37 / $158.37	Facility		$158.37	$158.37	$158.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.37 / $158.37 / $158.37	Professional		$158.37	$158.37	$158.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $131.68 / $164.60 / $181.06	Professional		$131.68	$164.60	$181.06
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $158.37 / $166.26 / $209.68	Facility		$158.37	$166.26	$209.68
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $150.44 / $158.37 / $197.69	Professional		$150.44	$158.37	$197.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $14.96 / $149.62 / $149.62	Facility		$14.96	$149.62	$149.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.07 / $130.69 / $161.36	Professional		$13.07	$130.69	$161.36
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $153.76 / $153.76 / $153.76	Facility		$153.76	$153.76	$153.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $14.50 / $14.50 / $17.66	Professional		$14.50	$14.50	$17.66
United Facility/Professional Professional Modifier Low / Median / High Price $83.39 / $84.19 / $160.24	Professional		$83.39	$84.19	$160.24