Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.24 / $109.34 / $109.34	Facility		$97.24	$109.34	$109.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.03 / $96.63 / $109.34	Professional		$92.03	$96.63	$109.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.78 / $91.78 / $91.78	Professional		$91.78	$91.78	$91.78
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $158.94 / $498.64 / $498.64	Facility		$158.94	$498.64	$498.64
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $112.54 / $208.65 / $823.05	Professional		$112.54	$208.65	$823.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.90 / $86.90 / $86.90	Professional		$86.90	$86.90	$86.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $140.16 / $250.39 / $301.87	Facility		$140.16	$250.39	$301.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.75 / $227.26 / $292.87	Professional		$100.75	$227.26	$292.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $80.00	Professional		$45.00	$50.00	$80.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $143.96 / $191.95 / $194.97	Facility		$143.96	$191.95	$194.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $127.29 / $127.29 / $127.29	Facility		$127.29	$127.29	$127.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.99 / $206.06 / $266.33	Professional		$132.99	$206.06	$266.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $121.09 / $145.31 / $184.06	Facility		$121.09	$145.31	$184.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $129.82 / $186.33 / $251.06	Professional		$129.82	$186.33	$251.06
United Facility/Professional Professional Modifier Low / Median / High Price $92.03 / $142.80 / $279.99	Professional		$92.03	$142.80	$279.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $80.61 / $80.61 / $105.80	Professional		$80.61	$80.61	$105.80