Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.43 / $283.50 / $17,930.00	Facility		$109.43	$283.50	$17,930.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.18 / $103.80 / $286.70	Professional		$54.18	$103.80	$286.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $116.92 / $116.92 / $116.92	Professional		$116.92	$116.92	$116.92
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $188.28 / $567.02 / $1,107.58	Facility		$188.28	$567.02	$1,107.58
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $84.16 / $249.80 / $1,020.56	Professional		$84.16	$249.80	$1,020.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.22 / $168.26 / $366.99	Professional		$78.22	$168.26	$366.99
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $87.00 / $159.37 / $356.60	Facility		$87.00	$159.37	$356.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $88.11 / $164.64 / $356.60	Professional		$88.11	$164.64	$356.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $200.24 / $357.19	Professional		$36.17	$200.24	$357.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $103.17 / $235.98 / $276.04	Facility		$103.17	$235.98	$276.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $187.54 / $187.54 / $188.28	Facility		$187.54	$187.54	$188.28
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $177.92 / $345.13	Professional		$84.00	$177.92	$345.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $367.90 / $567.35 / $1,085.27	Facility		$367.90	$567.35	$1,085.27
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $80.84 / $162.58 / $318.89	Professional		$80.84	$162.58	$318.89
United Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $648.00 / $5,793.00	Facility		$140.00	$648.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $150.41 / $198.51 / $398.74	Professional		$150.41	$198.51	$398.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $63.20 / $63.20 / $153.18	Professional		$63.20	$63.20	$153.18