Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.04 / $130.47 / $299.31	Professional		$106.04	$130.47	$299.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $224.24 / $224.24 / $224.24	Professional		$224.24	$224.24	$224.24
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,193.68 / $1,193.68	Facility		$100.00	$1,193.68	$1,193.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $26.67 / $202.08 / $313.93	Professional		$26.67	$202.08	$313.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.31 / $166.31 / $218.29	Facility		$166.31	$166.31	$218.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.36 / $166.31 / $218.29	Professional		$141.36	$166.31	$218.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $243.89 / $243.89 / $243.89	Facility		$243.89	$243.89	$243.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $243.89 / $243.89 / $243.89	Professional		$243.89	$243.89	$243.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $248.50 / $273.35	Professional		$75.00	$248.50	$273.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $243.89 / $254.21 / $316.55	Facility		$243.89	$254.21	$316.55
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $219.50 / $254.21 / $298.98	Professional		$219.50	$254.21	$298.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.90 / $229.00 / $229.00	Facility		$22.90	$229.00	$229.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.13 / $46.18 / $237.07	Professional		$20.13	$46.18	$237.07
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $236.79 / $236.79 / $236.79	Facility		$236.79	$236.79	$236.79
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $21.90 / $21.90 / $26.67	Professional		$21.90	$21.90	$26.67
United Facility/Professional Professional Modifier Low / Median / High Price $127.66 / $144.13 / $245.33	Professional		$127.66	$144.13	$245.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $276.14 / $276.14 / $276.14	Professional		$276.14	$276.14	$276.14