Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.67 / $248.95 / $259.92	Facility		$109.67	$248.95	$259.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.73 / $109.67 / $259.92	Professional		$87.73	$109.67	$259.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.32 / $162.52 / $208.00	Professional		$85.32	$162.52	$208.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $142.31 / $347.60 / $766.63	Facility		$142.31	$347.60	$766.63
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $113.82 / $142.31 / $855.46	Professional		$113.82	$142.31	$855.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.80 / $96.73 / $96.73	Facility		$95.80	$96.73	$96.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.61 / $70.61 / $177.42	Professional		$70.61	$70.61	$177.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $91.91 / $162.52 / $419.06	Facility		$91.91	$162.52	$419.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $92.01 / $162.52 / $310.31	Professional		$92.01	$162.52	$310.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $137.80 / $153.12 / $172.51	Professional		$137.80	$153.12	$172.51
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $129.00 / $158.71 / $162.52	Facility		$129.00	$158.71	$162.52
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $146.27 / $162.52 / $175.73	Professional		$146.27	$162.52	$175.73
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $142.31 / $182.52 / $317.42	Facility		$142.31	$182.52	$317.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $154.69 / $158.71 / $158.71	Facility		$154.69	$158.71	$158.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $129.11 / $138.13 / $178.77	Professional		$129.11	$138.13	$178.77
United Facility/Professional Professional Modifier Low / Median / High Price $67.38 / $78.61 / $139.04	Professional		$67.38	$78.61	$139.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $62.45 / $62.45 / $88.64	Professional		$62.45	$62.45	$88.64