Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.30 / $280.68 / $637.14	Facility		$90.30	$280.68	$637.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $188.51 / $249.49 / $973.44	Professional		$188.51	$249.49	$973.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.36 / $353.53 / $509.00	Professional		$218.36	$353.53	$509.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $364.20 / $629.55 / $1,620.96	Facility		$364.20	$629.55	$1,620.96
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $216.09 / $353.53 / $2,058.80	Professional		$216.09	$353.53	$2,058.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $214.16 / $214.16 / $291.73	Facility		$214.16	$214.16	$291.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.34 / $156.34 / $214.16	Professional		$156.34	$156.34	$214.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $248.00 / $424.24 / $1,188.18	Facility		$248.00	$424.24	$1,188.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $248.00 / $415.92 / $671.92	Professional		$248.00	$415.92	$671.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $286.96 / $318.85 / $350.73	Professional		$286.96	$318.85	$350.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $328.73 / $406.17 / $415.92	Facility		$328.73	$406.17	$415.92
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $330.41 / $330.41 / $415.92	Professional		$330.41	$330.41	$415.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $345.24 / $364.20 / $792.03	Facility		$345.24	$364.20	$792.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $345.24 / $371.48 / $467.10	Professional		$345.24	$371.48	$467.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $395.88 / $406.17 / $406.17	Facility		$395.88	$406.17	$406.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $330.41 / $353.53 / $457.51	Professional		$330.41	$353.53	$457.51
United Facility/Professional Facility Modifier Low / Median / High Price $122.08 / $154.24 / $170.91	Facility		$122.08	$154.24	$170.91
United Facility/Professional Professional Modifier Low / Median / High Price $154.24 / $155.62 / $296.91	Professional		$154.24	$155.62	$296.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $198.27 / $198.27 / $216.09	Professional		$198.27	$198.27	$216.09