Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.64 / $119.48 / $253.75	Professional		$90.64	$119.48	$253.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $119.35 / $119.35 / $119.35	Professional		$119.35	$119.35	$119.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $908.34 / $908.34	Facility		$100.00	$908.34	$908.34
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $25.39 / $152.21 / $304.58	Professional		$25.39	$152.21	$304.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.72 / $126.72 / $169.65	Facility		$126.72	$126.72	$169.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.71 / $126.72 / $207.75	Professional		$107.71	$126.72	$207.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $175.28 / $175.28 / $175.28	Facility		$175.28	$175.28	$175.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $175.28 / $175.28 / $175.28	Professional		$175.28	$175.28	$175.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $288.36 / $317.19	Professional		$75.00	$288.36	$317.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $175.28 / $181.27 / $367.34	Facility		$175.28	$181.27	$367.34
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $175.28 / $181.27 / $290.08	Professional		$175.28	$181.27	$290.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $19.59 / $195.92 / $238.24	Facility		$19.59	$195.92	$238.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.47 / $144.63 / $394.83	Professional		$14.47	$144.63	$394.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $170.17 / $170.17 / $170.17	Facility		$170.17	$170.17	$170.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $25.39 / $25.39 / $30.91	Professional		$25.39	$25.39	$30.91
United Facility/Professional Professional Modifier Low / Median / High Price $111.19 / $171.11 / $213.42	Professional		$111.19	$171.11	$213.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $268.12 / $268.12 / $268.12	Professional		$268.12	$268.12	$268.12