Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.20 / $281.82 / $460.72	Facility		$87.20	$281.82	$460.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.85 / $105.70 / $160.06	Professional		$84.85	$105.70	$160.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $132.15 / $132.15 / $176.20	Professional		$132.15	$132.15	$176.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $154.29 / $335.54 / $744.59	Facility		$154.29	$335.54	$744.59
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $110.04 / $153.29 / $914.49	Professional		$110.04	$153.29	$914.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.60 / $102.60 / $102.60	Facility		$102.60	$102.60	$102.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.90 / $74.90 / $102.60	Professional		$74.90	$74.90	$102.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $88.72 / $169.22 / $405.00	Facility		$88.72	$169.22	$405.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $88.82 / $167.39 / $299.55	Professional		$88.82	$167.39	$299.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $121.57 / $135.08 / $148.58	Professional		$121.57	$135.08	$148.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $139.86 / $167.81 / $176.20	Facility		$139.86	$167.81	$176.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $139.97 / $167.81 / $176.20	Professional		$139.97	$167.81	$176.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.29 / $197.88 / $344.14	Facility		$154.29	$197.88	$344.14
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $167.71 / $172.07 / $172.07	Facility		$167.71	$172.07	$172.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $139.97 / $149.77 / $193.82	Professional		$139.97	$149.77	$193.82
United Facility/Professional Professional Modifier Low / Median / High Price $66.34 / $76.03 / $134.47	Professional		$66.34	$76.03	$134.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $78.17 / $78.17 / $85.06	Professional		$78.17	$78.17	$85.06