Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.83 / $254.00 / $343.25	Facility		$144.83	$254.00	$343.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.07 / $144.83 / $343.25	Professional		$109.07	$144.83	$343.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $167.15 / $167.15 / $167.15	Professional		$167.15	$167.15	$167.15
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $195.15 / $424.42 / $1,135.98	Facility		$195.15	$424.42	$1,135.98
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $157.11 / $204.15 / $1,306.51	Professional		$157.11	$204.15	$1,306.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $170.15 / $170.15 / $170.15	Facility		$170.15	$170.15	$170.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.21 / $124.21 / $170.15	Professional		$124.21	$124.21	$170.15
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $128.31 / $222.87 / $585.00	Facility		$128.31	$222.87	$585.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.44 / $225.51 / $433.61	Professional		$128.44	$225.51	$433.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $153.77 / $170.86 / $187.94	Professional		$153.77	$170.86	$187.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $176.91 / $217.65 / $222.87	Facility		$176.91	$217.65	$222.87
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $200.58 / $222.87 / $245.16	Professional		$200.58	$222.87	$245.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $195.15 / $250.30 / $435.30	Facility		$195.15	$250.30	$435.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $212.13 / $217.65 / $217.65	Facility		$212.13	$217.65	$217.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $177.06 / $189.44 / $245.16	Professional		$177.06	$189.44	$245.16
United Facility/Professional Professional Modifier Low / Median / High Price $101.84 / $153.44 / $194.31	Professional		$101.84	$153.44	$194.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.79 / $83.79 / $189.44	Professional		$83.79	$83.79	$189.44