Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $299.37 / $707.38 / $13,750.00	Facility		$299.37	$707.38	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.84 / $207.68 / $425.52	Professional		$103.84	$207.68	$425.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $99.80 / $121.46 / $253.53	Professional		$99.80	$121.46	$253.53
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $336.81 / $1,130.00 / $2,923.64	Facility		$336.81	$1,130.00	$2,923.64
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $226.08 / $475.19 / $1,827.60	Professional		$226.08	$475.19	$1,827.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.39 / $421.10 / $731.00	Facility		$243.39	$421.10	$731.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $206.68 / $346.69 / $654.26	Professional		$206.68	$346.69	$654.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $211.50 / $347.80 / $591.46	Facility		$211.50	$347.80	$591.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $221.37 / $363.84 / $591.46	Professional		$221.37	$363.84	$591.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.35 / $329.93 / $581.00	Professional		$58.35	$329.93	$581.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $229.64 / $347.03 / $493.68	Facility		$229.64	$347.03	$493.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $149.99 / $328.88 / $336.81	Facility		$149.99	$328.88	$336.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $227.01 / $380.31 / $617.38	Professional		$227.01	$380.31	$617.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $824.54 / $1,129.34 / $2,161.55	Facility		$824.54	$1,129.34	$2,161.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $217.60 / $335.41 / $570.44	Professional		$217.60	$335.41	$570.44
United Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $414.00 / $5,793.00	Facility		$140.00	$414.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $294.83 / $365.04 / $705.16	Professional		$294.83	$365.04	$705.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $176.22 / $176.22 / $274.08	Professional		$176.22	$176.22	$274.08