Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.76 / $90.76 / $90.76	Facility		$90.76	$90.76	$90.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.91 / $104.01 / $147.13	Professional		$88.91	$104.01	$147.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $179.76 / $179.76 / $179.76	Professional		$179.76	$179.76	$179.76
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $171.26 / $225.90 / $544.91	Facility		$171.26	$225.90	$544.91
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $141.87 / $251.59 / $905.63	Professional		$141.87	$251.59	$905.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.42 / $96.42 / $96.42	Professional		$96.42	$96.42	$96.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $98.25 / $210.14 / $327.64	Facility		$98.25	$210.14	$327.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.03 / $177.10 / $268.93	Professional		$97.03	$177.10	$268.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.52 / $160.40 / $274.75	Professional		$27.52	$160.40	$274.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $159.25 / $209.04 / $219.09	Facility		$159.25	$209.04	$219.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $148.58 / $187.32 / $225.90	Facility		$148.58	$187.32	$225.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.62 / $246.99 / $296.64	Professional		$157.62	$246.99	$296.64
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $134.81 / $161.78 / $228.80	Facility		$134.81	$161.78	$228.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $151.54 / $210.76 / $280.58	Professional		$151.54	$210.76	$280.58
United Facility/Professional Professional Modifier Low / Median / High Price $119.50 / $180.53 / $313.82	Professional		$119.50	$180.53	$313.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.44 / $89.44 / $114.18	Professional		$89.44	$89.44	$114.18