Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.34 / $368.51 / $384.75	Facility		$162.34	$368.51	$384.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.30 / $209.42 / $345.48	Professional		$114.30	$209.42	$345.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $397.17 / $397.17 / $404.43	Professional		$397.17	$397.17	$404.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $132.97 / $398.36 / $1,352.24	Facility		$132.97	$398.36	$1,352.24
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $116.42 / $204.02 / $962.90	Professional		$116.42	$204.02	$962.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $301.51 / $301.51 / $301.51	Facility		$301.51	$301.51	$301.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.10 / $220.10 / $314.97	Professional		$220.10	$220.10	$314.97
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $130.11 / $525.29 / $1,380.94	Facility		$130.11	$525.29	$1,380.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $130.11 / $505.06 / $881.38	Professional		$130.11	$505.06	$881.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $333.52 / $370.58 / $407.63	Professional		$333.52	$370.58	$407.63
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $136.96 / $204.11 / $397.17	Facility		$136.96	$204.11	$397.17
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.02 / $205.55 / $265.94	Facility		$113.02	$205.55	$265.94
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.02 / $201.82 / $397.31	Professional		$113.02	$201.82	$397.31
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $132.97 / $132.97 / $214.76	Facility		$132.97	$132.97	$214.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $110.60 / $117.79 / $384.02	Professional		$110.60	$117.79	$384.02
United Facility/Professional Professional Modifier Low / Median / High Price $207.82 / $220.78 / $367.97	Professional		$207.82	$220.78	$367.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $283.76 / $284.08 / $284.08	Professional		$283.76	$284.08	$284.08