Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.56 / $167.00 / $285.06	Facility		$73.56	$167.00	$285.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.96 / $73.56 / $167.00	Professional		$60.96	$73.56	$167.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.78 / $81.78 / $81.78	Professional		$81.78	$81.78	$81.78
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $95.46 / $250.98 / $490.51	Facility		$95.46	$250.98	$490.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $71.33 / $92.70 / $793.53	Professional		$71.33	$92.70	$793.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.72 / $62.72 / $62.72	Facility		$62.72	$62.72	$62.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.79 / $45.79 / $62.72	Professional		$45.79	$45.79	$62.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $58.24 / $109.03 / $263.43	Facility		$58.24	$109.03	$263.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.30 / $105.91 / $195.29	Professional		$58.30	$105.91	$195.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $83.58 / $91.93	Professional		$75.22	$83.58	$91.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $86.55 / $106.47 / $119.54	Facility		$86.55	$106.47	$119.54
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $98.13 / $109.03 / $119.54	Professional		$98.13	$109.03	$119.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.46 / $122.44 / $212.94	Facility		$95.46	$122.44	$212.94
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.50 / $90.50 / $90.50	Professional		$90.50	$90.50	$90.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $103.77 / $106.47 / $106.47	Facility		$103.77	$106.47	$106.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $86.61 / $92.68 / $119.93	Professional		$86.61	$92.68	$119.93
United Facility/Professional Facility Modifier Low / Median / High Price $123.01 / $147.61 / $147.61	Facility		$123.01	$147.61	$147.61
United Facility/Professional Professional Modifier Low / Median / High Price $42.56 / $46.10 / $87.81	Professional		$42.56	$46.10	$87.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $55.44 / $60.37 / $60.37	Professional		$55.44	$60.37	$60.37