Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.45 / $98.76 / $198.51	Facility		$87.45	$98.76	$198.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.14 / $77.73 / $221.22	Professional		$40.14	$77.73	$221.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.03 / $97.19 / $155.33	Professional		$68.03	$97.19	$155.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $113.47 / $278.41 / $670.88	Facility		$113.47	$278.41	$670.88
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $92.00 / $121.74 / $868.37	Professional		$92.00	$121.74	$868.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.64 / $86.64 / $91.83	Facility		$86.64	$86.64	$91.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.25 / $63.25 / $91.83	Professional		$63.25	$63.25	$91.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $78.26 / $132.26 / $288.04	Facility		$78.26	$132.26	$288.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $78.34 / $133.32 / $264.80	Professional		$78.34	$133.32	$264.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $89.39 / $99.33 / $109.26	Professional		$89.39	$99.33	$109.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $102.85 / $124.66 / $129.59	Facility		$102.85	$124.66	$129.59
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $116.63 / $129.59 / $129.59	Professional		$116.63	$129.59	$129.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.47 / $145.53 / $253.10	Facility		$113.47	$145.53	$253.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $123.34 / $126.55 / $126.55	Facility		$123.34	$126.55	$126.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $102.93 / $110.15 / $142.55	Professional		$102.93	$110.15	$142.55
United Facility/Professional Professional Modifier Low / Median / High Price $57.50 / $62.30 / $118.65	Professional		$57.50	$62.30	$118.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $62.45 / $62.45 / $110.15	Professional		$62.45	$62.45	$110.15