Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $336.32 / $718.87 / $14,464.32	Facility		$336.32	$718.87	$14,464.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.93 / $251.56 / $526.57	Professional		$154.93	$251.56	$526.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $276.35 / $276.35 / $276.35	Professional		$276.35	$276.35	$276.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $369.26 / $1,993.85 / $5,158.68	Facility		$369.26	$1,993.85	$5,158.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $254.88 / $519.86 / $1,998.72	Professional		$254.88	$519.86	$1,998.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $257.01 / $421.10 / $731.00	Facility		$257.01	$421.10	$731.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.55 / $381.79 / $715.56	Professional		$232.55	$381.79	$715.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $237.60 / $396.34 / $644.39	Facility		$237.60	$396.34	$644.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $247.03 / $404.07 / $644.39	Professional		$247.03	$404.07	$644.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.58 / $269.22 / $597.82	Professional		$44.58	$269.22	$597.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $246.71 / $438.90 / $541.36	Facility		$246.71	$438.90	$541.36
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.03 / $360.59 / $369.26	Facility		$158.03	$360.59	$369.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $256.14 / $429.13 / $676.86	Professional		$256.14	$429.13	$676.86
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 $245.32 / $367.75 / $625.39	Professional		$245.32	$367.75	$625.39
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 $322.98 / $400.20 / $772.46	Professional		$322.98	$400.20	$772.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $197.34 / $197.34 / $298.76	Professional		$197.34	$197.34	$298.76