Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $258.72 / $409.99	Facility		$92.60	$258.72	$409.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.89 / $180.61 / $581.00	Professional		$94.89	$180.61	$581.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $200.72 / $222.97 / $454.95	Professional		$200.72	$222.97	$454.95
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $234.34 / $457.36 / $1,281.52	Facility		$234.34	$457.36	$1,281.52
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $193.36 / $234.34 / $1,380.26	Professional		$193.36	$234.34	$1,380.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $142.00 / $142.00 / $146.03	Facility		$142.00	$142.00	$146.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.66 / $103.66 / $146.03	Professional		$103.66	$103.66	$146.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $194.68 / $307.76 / $764.53	Facility		$194.68	$307.76	$764.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.68 / $304.61 / $525.47	Professional		$194.68	$304.61	$525.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $184.64 / $205.16 / $225.67	Professional		$184.64	$205.16	$225.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $261.35 / $267.62 / $277.16	Facility		$261.35	$267.62	$277.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $222.15 / $234.34 / $509.63	Facility		$222.15	$234.34	$509.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.15 / $241.99 / $300.55	Professional		$222.15	$241.99	$300.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $254.73 / $261.35 / $261.35	Facility		$254.73	$261.35	$261.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $212.60 / $227.48 / $294.38	Professional		$212.60	$227.48	$294.38
United Facility/Professional Professional Modifier Low / Median / High Price $121.11 / $133.51 / $233.14	Professional		$121.11	$133.51	$233.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $139.35 / $139.35 / $227.48	Professional		$139.35	$139.35	$227.48