Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.41 / $168.91 / $176.35	Facility		$74.41	$168.91	$176.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.00 / $66.15 / $231.00	Professional		$41.00	$66.15	$231.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.73 / $110.27 / $121.00	Professional		$93.73	$110.27	$121.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $96.56 / $210.00 / $472.21	Facility		$96.56	$210.00	$472.21
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $69.41 / $93.73 / $593.54	Professional		$69.41	$93.73	$593.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.94 / $58.00 / $58.00	Facility		$56.94	$58.00	$58.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.34 / $42.34 / $58.00	Professional		$42.34	$42.34	$58.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $56.42 / $107.69 / $257.81	Facility		$56.42	$107.69	$257.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.48 / $105.65 / $190.32	Professional		$56.48	$105.65	$190.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.52 / $103.92 / $117.05	Professional		$93.52	$103.92	$117.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $87.54 / $98.92 / $110.27	Facility		$87.54	$98.92	$110.27
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $89.93 / $110.27 / $110.27	Professional		$89.93	$110.27	$110.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $96.56 / $123.84 / $215.38	Facility		$96.56	$123.84	$215.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $91.54 / $91.54	Professional		$91.54	$91.54	$91.54
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $104.96 / $107.69 / $107.69	Facility		$104.96	$107.69	$107.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $87.60 / $93.73 / $121.30	Professional		$87.60	$93.73	$121.30
United Facility/Professional Professional Modifier Low / Median / High Price $41.48 / $44.94 / $85.60	Professional		$41.48	$44.94	$85.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.16 / $42.16 / $54.74	Professional		$42.16	$42.16	$54.74