Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $286.76 / $631.73 / $17,100.00	Facility		$286.76	$631.73	$17,100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.96 / $204.65 / $406.40	Professional		$133.96	$204.65	$406.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $244.97 / $244.97 / $244.97	Professional		$244.97	$244.97	$244.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $326.30 / $1,993.85 / $5,158.68	Facility		$326.30	$1,993.85	$5,158.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $217.44 / $460.95 / $1,766.72	Professional		$217.44	$460.95	$1,766.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.82 / $421.10 / $731.00	Facility		$234.82	$421.10	$731.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.15 / $333.44 / $633.36	Professional		$199.15	$333.44	$633.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $201.69 / $336.88 / $603.66	Facility		$201.69	$336.88	$603.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $211.80 / $350.19 / $573.10	Professional		$211.80	$350.19	$573.10
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 $220.59 / $384.18 / $478.38	Facility		$220.59	$384.18	$478.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $143.63 / $318.91 / $326.30	Facility		$143.63	$318.91	$326.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $219.02 / $367.04 / $598.12	Professional		$219.02	$367.04	$598.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,292.92 / $1,992.71 / $3,814.01	Facility		$1,292.92	$1,992.71	$3,814.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $209.29 / $325.25 / $552.64	Professional		$209.29	$325.25	$552.64
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 $284.76 / $362.80 / $676.41	Professional		$284.76	$362.80	$676.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $169.73 / $169.73 / $264.83	Professional		$169.73	$169.73	$264.83