Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.22 / $213.88 / $223.30	Facility		$94.22	$213.88	$223.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.10 / $94.22 / $163.00	Professional		$48.10	$94.22	$163.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $108.74 / $108.74 / $144.99	Professional		$108.74	$108.74	$144.99
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $126.96 / $289.97 / $720.02	Facility		$126.96	$289.97	$720.02
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $95.16 / $151.52 / $1,061.93	Professional		$95.16	$151.52	$1,061.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.00 / $128.85 / $128.85	Facility		$126.00	$128.85	$128.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.52 / $109.52 / $128.85	Professional		$109.52	$109.52	$128.85
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $91.00 / $153.80 / $397.30	Facility		$91.00	$153.80	$397.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.10 / $155.25 / $307.00	Professional		$91.10	$155.25	$307.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $122.96 / $136.63 / $153.91	Professional		$122.96	$136.63	$153.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $115.09 / $141.59 / $144.99	Facility		$115.09	$141.59	$144.99
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $130.49 / $144.99 / $153.69	Professional		$130.49	$144.99	$153.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $126.96 / $162.83 / $283.18	Facility		$126.96	$162.83	$283.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $138.00 / $141.59 / $141.59	Facility		$138.00	$141.59	$141.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $105.84 / $159.49 / $159.49	Professional		$105.84	$159.49	$159.49
United Facility/Professional Professional Modifier Low / Median / High Price $72.34 / $108.96 / $138.00	Professional		$72.34	$108.96	$138.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $123.24 / $124.90 / $124.90	Professional		$123.24	$124.90	$124.90