Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.65 / $104.74 / $184.03	Facility		$77.65	$104.74	$184.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.18 / $69.58 / $150.00	Professional		$39.18	$69.58	$150.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $155.36 / $155.36 / $155.36	Professional		$155.36	$155.36	$155.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.76 / $239.32 / $549.05	Facility		$100.76	$239.32	$549.05
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $81.94 / $100.12 / $593.47	Professional		$81.94	$100.12	$593.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.96 / $65.81 / $383.66	Facility		$41.96	$65.81	$383.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.04 / $48.04 / $71.19	Professional		$48.04	$48.04	$71.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $66.43 / $115.08 / $301.87	Facility		$66.43	$115.08	$301.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.50 / $116.75 / $223.42	Professional		$66.50	$116.75	$223.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.39 / $88.22 / $97.04	Professional		$79.39	$88.22	$97.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $91.35 / $112.38 / $119.17	Facility		$91.35	$112.38	$119.17
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $91.42 / $115.08 / $126.59	Professional		$91.42	$115.08	$126.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.76 / $129.24 / $224.76	Facility		$100.76	$129.24	$224.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.52 / $95.52 / $95.52	Professional		$95.52	$95.52	$95.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $109.53 / $112.38 / $112.38	Facility		$109.53	$112.38	$112.38
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $91.42 / $97.82 / $126.59	Professional		$91.42	$97.82	$126.59
United Facility/Professional Facility Modifier Low / Median / High Price $140.44 / $168.53 / $168.53	Facility		$140.44	$168.53	$168.53
United Facility/Professional Professional Modifier Low / Median / High Price $48.59 / $52.55 / $100.25	Professional		$48.59	$52.55	$100.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.40 / $54.40 / $97.82	Professional		$54.40	$54.40	$97.82