Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $200.70 / $571.87 / $9,703.00	Facility		$200.70	$571.87	$9,703.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.76 / $183.52 / $411.12	Professional		$91.76	$183.52	$411.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.15 / $157.36 / $425.41	Professional		$84.15	$157.36	$425.41
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $283.33 / $4,591.92 / $9,102.00	Facility		$283.33	$4,591.92	$9,102.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $216.62 / $424.39 / $1,533.68	Professional		$216.62	$424.39	$1,533.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $195.02 / $421.10 / $731.00	Facility		$195.02	$421.10	$731.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.62 / $302.35 / $548.74	Professional		$195.62	$302.35	$548.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $194.06 / $309.44 / $508.30	Facility		$194.06	$309.44	$508.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.88 / $314.94 / $493.97	Professional		$194.88	$314.94	$493.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.65 / $279.63 / $494.90	Professional		$49.65	$279.63	$494.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $181.64 / $266.91 / $405.74	Facility		$181.64	$266.91	$405.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.49 / $276.33 / $283.33	Facility		$112.49	$276.33	$283.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.78 / $369.68 / $519.37	Professional		$222.78	$369.68	$519.37
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,264.85 / $4,591.92 / $8,788.86	Facility		$3,264.85	$4,591.92	$8,788.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $210.67 / $310.31 / $497.23	Professional		$210.67	$310.31	$497.23
United Facility/Professional Facility Modifier Low / Median / High Price $629.00 / $1,120.00 / $6,857.00	Facility		$629.00	$1,120.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $243.49 / $310.89 / $583.61	Professional		$243.49	$310.89	$583.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $174.70 / $174.70 / $229.95	Professional		$174.70	$174.70	$229.95