Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $224.18 / $1,096.00 / $10,122.46	Facility		$224.18	$1,096.00	$10,122.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.14 / $172.28 / $384.27	Professional		$86.14	$172.28	$384.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $196.72 / $196.72 / $363.93	Professional		$196.72	$196.72	$363.93
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $273.29 / $1,993.85 / $5,158.68	Facility		$273.29	$1,993.85	$5,158.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $206.56 / $400.25 / $1,475.04	Professional		$206.56	$400.25	$1,475.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.01 / $421.10 / $731.00	Facility		$194.01	$421.10	$731.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.77 / $287.54 / $529.49	Professional		$186.77	$287.54	$529.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $184.00 / $295.04 / $485.15	Facility		$184.00	$295.04	$485.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $186.47 / $301.45 / $476.41	Professional		$186.47	$301.45	$476.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $46.29 / $246.96 / $462.61	Professional		$46.29	$246.96	$462.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $181.64 / $264.05 / $389.68	Facility		$181.64	$264.05	$389.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.16 / $266.82 / $273.29	Facility		$112.16	$266.82	$273.29
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $212.44 / $353.02 / $500.94	Professional		$212.44	$353.02	$500.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,454.88 / $1,992.71 / $3,814.01	Facility		$1,454.88	$1,992.71	$3,814.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $200.97 / $296.02 / $474.15	Professional		$200.97	$296.02	$474.15
United Facility/Professional Facility Modifier Low / Median / High Price $350.00 / $887.00 / $4,611.00	Facility		$350.00	$887.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $225.00 / $277.60 / $573.51	Professional		$225.00	$277.60	$573.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $166.49 / $166.49 / $221.73	Professional		$166.49	$166.49	$221.73