Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.94 / $546.34 / $579.26	Facility		$130.94	$546.34	$579.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.07 / $119.13 / $301.07	Professional		$100.07	$119.13	$301.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $145.52 / $145.52 / $194.02	Professional		$145.52	$145.52	$194.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $169.89 / $410.45 / $939.42	Facility		$169.89	$410.45	$939.42
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $129.33 / $168.80 / $1,006.48	Professional		$129.33	$168.80	$1,006.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.67 / $112.67 / $112.67	Facility		$112.67	$112.67	$112.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.25 / $82.25 / $115.34	Professional		$82.25	$82.25	$115.34
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $113.29 / $194.02 / $515.62	Facility		$113.29	$194.02	$515.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $113.41 / $197.90 / $382.30	Professional		$113.41	$197.90	$382.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $133.87 / $148.75 / $163.62	Professional		$133.87	$148.75	$163.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $154.04 / $189.47 / $200.73	Facility		$154.04	$189.47	$200.73
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $174.62 / $194.02 / $200.73	Professional		$174.62	$194.02	$200.73
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.89 / $217.89 / $378.94	Facility		$169.89	$217.89	$378.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $184.67 / $189.47 / $189.47	Facility		$184.67	$189.47	$189.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $154.15 / $164.92 / $213.42	Professional		$154.15	$164.92	$213.42
United Facility/Professional Professional Modifier Low / Median / High Price $83.17 / $103.97 / $171.62	Professional		$83.17	$103.97	$171.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $106.87 / $106.87 / $109.27	Professional		$106.87	$106.87	$109.27