Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.20 / $123.03 / $128.44	Facility		$54.20	$123.03	$128.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.35 / $54.20 / $128.44	Professional		$30.35	$54.20	$128.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.58 / $60.58 / $60.58	Professional		$60.58	$60.58	$60.58
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $129.91 / $190.22 / $444.69	Facility		$129.91	$190.22	$444.69
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $78.87 / $80.77 / $695.93	Professional		$78.87	$80.77	$695.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.77 / $38.77 / $38.77	Professional		$38.77	$38.77	$38.77
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $76.26 / $135.41 / $196.72	Facility		$76.26	$135.41	$196.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.66 / $135.41 / $200.65	Professional		$77.66	$135.41	$200.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $83.51 / $102.06 / $104.52	Professional		$83.51	$102.06	$104.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $92.79 / $95.02 / $104.52	Facility		$92.79	$95.02	$104.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.20 / $166.40 / $246.82	Facility		$83.20	$166.40	$246.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.87 / $92.79 / $106.71	Professional		$78.87	$92.79	$106.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $76.73 / $80.77 / $95.02	Professional		$76.73	$80.77	$95.02
United Facility/Professional Professional Modifier Low / Median / High Price $40.29 / $48.46 / $76.87	Professional		$40.29	$48.46	$76.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $80.77 / $80.77 / $95.02	Professional		$80.77	$80.77	$95.02