Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.82 / $285.61 / $298.19	Facility		$125.82	$285.61	$298.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.85 / $125.82 / $382.32	Professional		$106.85	$125.82	$382.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.82 / $186.43 / $223.72	Professional		$139.82	$186.43	$223.72
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $163.25 / $318.61 / $889.53	Facility		$163.25	$318.61	$889.53
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $112.34 / $163.25 / $961.74	Professional		$112.34	$163.25	$961.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $118.47 / $120.81 / $120.81	Facility		$118.47	$120.81	$120.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.19 / $88.19 / $120.81	Professional		$88.19	$88.19	$120.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $135.78 / $214.39 / $532.64	Facility		$135.78	$214.39	$532.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $135.78 / $212.32 / $366.00	Professional		$135.78	$212.32	$366.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $128.64 / $142.94 / $157.23	Professional		$128.64	$142.94	$157.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $177.11 / $186.43 / $193.12	Facility		$177.11	$186.43	$193.12
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $148.12 / $148.12 / $148.12	Professional		$148.12	$148.12	$148.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.75 / $163.25 / $355.02	Facility		$154.75	$163.25	$355.02
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.75 / $168.58 / $209.37	Professional		$154.75	$168.58	$209.37
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $177.45 / $182.06 / $182.06	Facility		$177.45	$182.06	$182.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $148.12 / $158.47 / $205.07	Professional		$148.12	$158.47	$205.07
United Facility/Professional Professional Modifier Low / Median / High Price $81.02 / $90.20 / $162.41	Professional		$81.02	$90.20	$162.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.34 / $114.90 / $114.90	Professional		$112.34	$114.90	$114.90