Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.06 / $154.52 / $161.33	Facility		$68.06	$154.52	$161.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $68.06 / $161.33	Professional		$40.00	$68.06	$161.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.74 / $104.74 / $104.74	Professional		$104.74	$104.74	$104.74
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $91.72 / $235.25 / $426.39	Facility		$91.72	$235.25	$426.39
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $64.34 / $89.03 / $743.72	Professional		$64.34	$89.03	$743.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.74 / $51.74 / $51.74	Facility		$51.74	$51.74	$51.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.77 / $37.77 / $51.74	Professional		$37.77	$37.77	$51.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $50.50 / $99.50 / $228.75	Facility		$50.50	$99.50	$228.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.56 / $99.50 / $169.63	Professional		$50.56	$99.50	$169.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.27 / $80.30 / $88.33	Professional		$72.27	$80.30	$88.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $78.12 / $90.18 / $104.74	Facility		$78.12	$90.18	$104.74
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $79.98 / $104.74 / $109.98	Professional		$79.98	$104.74	$109.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.72 / $117.63 / $204.58	Facility		$91.72	$117.63	$204.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.95 / $86.95 / $86.95	Professional		$86.95	$86.95	$86.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $99.70 / $102.29 / $102.29	Facility		$99.70	$102.29	$102.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $83.21 / $89.03 / $115.21	Professional		$83.21	$89.03	$115.21
United Facility/Professional Professional Modifier Low / Median / High Price $39.90 / $61.07 / $76.14	Professional		$39.90	$61.07	$76.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.32 / $46.32 / $89.03	Professional		$46.32	$46.32	$89.03