Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.09 / $365.19 / $867.00	Facility		$154.09	$365.19	$867.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.54 / $154.09 / $492.00	Professional		$125.54	$154.09	$492.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $171.24 / $171.24 / $171.24	Professional		$171.24	$171.24	$171.24
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $199.93 / $474.94 / $1,089.41	Facility		$199.93	$474.94	$1,089.41
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $162.60 / $199.81 / $1,177.86	Professional		$162.60	$199.81	$1,177.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.25 / $130.59 / $130.59	Facility		$83.25	$130.59	$130.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.33 / $95.33 / $176.78	Professional		$95.33	$95.33	$176.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $138.72 / $236.89 / $625.76	Facility		$138.72	$236.89	$625.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $146.63 / $240.85 / $443.54	Professional		$146.63	$240.85	$443.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.26 / $157.54 / $192.55	Professional		$19.26	$157.54	$192.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $181.26 / $222.97 / $236.52	Facility		$181.26	$222.97	$236.52
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $181.40 / $228.32 / $236.52	Professional		$181.40	$228.32	$236.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $199.93 / $256.42 / $445.94	Facility		$199.93	$256.42	$445.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $217.32 / $222.97 / $222.97	Facility		$217.32	$222.97	$222.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $181.40 / $194.07 / $251.15	Professional		$181.40	$194.07	$251.15
United Facility/Professional Professional Modifier Low / Median / High Price $96.41 / $104.44 / $198.92	Professional		$96.41	$104.44	$198.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $127.31 / $194.07 / $194.07	Professional		$127.31	$194.07	$194.07