Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.32 / $129.60 / $247.15	Professional		$107.32	$129.60	$247.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $217.54 / $217.54 / $251.53	Professional		$217.54	$217.54	$251.53
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $659.65 / $659.65 / $659.65	Facility		$659.65	$659.65	$659.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $180.64 / $289.33 / $1,094.70	Professional		$180.64	$289.33	$1,094.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.76 / $115.76 / $115.76	Professional		$115.76	$115.76	$115.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $122.14 / $216.32 / $323.17	Facility		$122.14	$216.32	$323.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.14 / $219.65 / $326.30	Professional		$122.14	$219.65	$326.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.26 / $211.69 / $390.79	Professional		$38.26	$211.69	$390.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $213.68 / $254.37 / $265.20	Facility		$213.68	$254.37	$265.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.33 / $289.33 / $352.86	Professional		$198.33	$289.33	$352.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $180.64 / $251.55 / $332.56	Professional		$180.64	$251.55	$332.56
United Facility/Professional Professional Modifier Low / Median / High Price $155.38 / $221.84 / $379.16	Professional		$155.38	$221.84	$379.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.39 / $107.39 / $107.39	Professional		$107.39	$107.39	$107.39