Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $355.86 / $750.83 / $13,750.00	Facility		$355.86	$750.83	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.19 / $246.71 / $511.03	Professional		$129.19	$246.71	$511.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.81 / $140.97 / $574.46	Professional		$113.81	$140.97	$574.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $383.42 / $1,993.85 / $5,158.68	Facility		$383.42	$1,993.85	$5,158.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $265.99 / $542.66 / $2,078.96	Professional		$265.99	$542.66	$2,078.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.05 / $421.10 / $731.00	Facility		$263.05	$421.10	$731.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.34 / $400.43 / $743.00	Professional		$246.34	$400.43	$743.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $251.72 / $408.17 / $671.93	Facility		$251.72	$408.17	$671.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $252.84 / $423.22 / $671.93	Professional		$252.84	$423.22	$671.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.96 / $208.24 / $580.82	Professional		$34.96	$208.24	$580.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $247.58 / $390.05 / $561.67	Facility		$247.58	$390.05	$561.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.38 / $374.18 / $383.42	Facility		$162.38	$374.18	$383.42
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $271.19 / $455.35 / $702.83	Professional		$271.19	$455.35	$702.83
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 $260.11 / $383.12 / $649.39	Professional		$260.11	$383.12	$649.39
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 $268.80 / $383.52 / $790.61	Professional		$268.80	$383.52	$790.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $209.49 / $209.49 / $310.52	Professional		$209.49	$209.49	$310.52