Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $260.26 / $1,710.00 / $13,750.00	Facility		$260.26	$1,710.00	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.39 / $178.98 / $381.59	Professional		$109.39	$178.98	$381.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $87.27 / $95.90	Professional		$78.68	$87.27	$95.90
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $266.89 / $1,993.85 / $5,158.68	Facility		$266.89	$1,993.85	$5,158.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $202.97 / $398.80 / $1,442.72	Professional		$202.97	$398.80	$1,442.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $192.00 / $421.10 / $731.00	Facility		$192.00	$421.10	$731.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.30 / $281.93 / $517.66	Professional		$184.30	$281.93	$517.66
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $182.59 / $292.44 / $475.24	Facility		$182.59	$292.44	$475.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $182.68 / $297.47 / $467.94	Professional		$182.68	$297.47	$467.94
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 $181.68 / $274.23 / $381.90	Facility		$181.68	$274.23	$381.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.49 / $260.93 / $266.89	Facility		$111.49	$260.93	$266.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.68 / $347.47 / $493.68	Professional		$208.68	$347.47	$493.68
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 $198.20 / $291.89 / $465.76	Professional		$198.20	$291.89	$465.76
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 $225.50 / $282.37 / $560.94	Professional		$225.50	$282.37	$560.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $163.53 / $163.53 / $216.41	Professional		$163.53	$163.53	$216.41