Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.13 / $161.47 / $168.58	Facility		$71.13	$161.47	$168.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.04 / $71.13 / $219.00	Professional		$60.04	$71.13	$219.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.40 / $105.40 / $113.00	Professional		$105.40	$105.40	$113.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $92.29 / $180.13 / $474.60	Facility		$92.29	$180.13	$474.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $68.09 / $92.29 / $521.73	Professional		$68.09	$92.29	$521.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.32 / $61.21 / $61.21	Facility		$60.32	$61.21	$61.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.68 / $44.68 / $61.21	Professional		$44.68	$44.68	$61.21
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $76.26 / $121.21 / $301.08	Facility		$76.26	$121.21	$301.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $76.26 / $119.55 / $205.83	Professional		$76.26	$119.55	$205.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.72 / $80.80 / $88.88	Professional		$72.72	$80.80	$88.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $93.65 / $102.93 / $105.40	Facility		$93.65	$102.93	$105.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.49 / $92.29 / $200.71	Facility		$87.49	$92.29	$200.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.49 / $95.30 / $151.47	Professional		$87.49	$95.30	$151.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $100.32 / $102.93 / $102.93	Facility		$100.32	$102.93	$102.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $83.73 / $89.59 / $115.94	Professional		$83.73	$89.59	$115.94
United Facility/Professional Facility Modifier Low / Median / High Price $127.86 / $153.43 / $153.43	Facility		$127.86	$153.43	$153.43
United Facility/Professional Professional Modifier Low / Median / High Price $45.53 / $52.54 / $91.27	Professional		$45.53	$52.54	$91.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.48 / $23.48 / $89.59	Professional		$23.48	$23.48	$89.59