Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.04 / $39.31 / $169.89	Facility		$38.04	$39.31	$169.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.28 / $66.53 / $287.00	Professional		$34.28	$66.53	$287.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $49.23 / $110.89 / $110.89	Professional		$49.23	$110.89	$110.89
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $97.10 / $264.33 / $535.05	Facility		$97.10	$264.33	$535.05
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $95.67 / $835.47	Professional		$77.62	$95.67	$835.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.22 / $68.22 / $73.06	Facility		$68.22	$68.22	$73.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.80 / $49.80 / $73.06	Professional		$49.80	$49.80	$73.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $63.24 / $110.89 / $288.75	Facility		$63.24	$110.89	$288.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.31 / $111.15 / $213.49	Professional		$63.31	$111.15	$213.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.05 / $104.50 / $117.71	Professional		$94.05	$104.50	$117.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $88.04 / $100.70 / $110.89	Facility		$88.04	$100.70	$110.89
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $99.80 / $110.77 / $110.89	Professional		$99.80	$110.77	$110.89
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.10 / $124.53 / $216.58	Facility		$97.10	$124.53	$216.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.05 / $92.05 / $92.05	Professional		$92.05	$92.05	$92.05
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $105.55 / $108.29 / $108.29	Facility		$105.55	$108.29	$108.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $88.11 / $94.26 / $121.98	Professional		$88.11	$94.26	$121.98
United Facility/Professional Professional Modifier Low / Median / High Price $46.45 / $50.24 / $95.85	Professional		$46.45	$50.24	$95.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.34 / $64.53 / $64.53	Professional		$61.34	$64.53	$64.53