Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.94 / $297.23 / $310.33	Facility		$130.94	$297.23	$310.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.90 / $130.94 / $226.53	Professional		$112.90	$130.94	$226.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $145.52 / $155.33 / $194.02	Professional		$145.52	$155.33	$194.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $169.89 / $331.57 / $939.42	Facility		$169.89	$331.57	$939.42
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $140.28 / $169.89 / $1,006.48	Professional		$140.28	$169.89	$1,006.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.02 / $127.07 / $127.07	Facility		$106.02	$127.07	$127.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.76 / $92.76 / $128.69	Professional		$92.76	$92.76	$128.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $143.22 / $223.79 / $554.33	Facility		$143.22	$223.79	$554.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $143.22 / $223.12 / $386.37	Professional		$143.22	$223.12	$386.37
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 $189.47 / $194.02 / $200.73	Facility		$189.47	$194.02	$200.73
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $154.15 / $154.15 / $154.15	Professional		$154.15	$154.15	$154.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $161.05 / $169.89 / $369.47	Facility		$161.05	$169.89	$369.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $161.05 / $175.44 / $217.89	Professional		$161.05	$175.44	$217.89
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 $85.60 / $98.78 / $171.62	Professional		$85.60	$98.78	$171.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $106.87 / $106.87 / $115.83	Professional		$106.87	$106.87	$115.83