Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.98 / $198.99 / $13,750.00	Facility		$83.98	$198.99	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.02 / $65.25 / $156.55	Professional		$42.02	$65.25	$156.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.46 / $96.83 / $127.81	Professional		$57.46	$96.83	$127.81
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $117.00 / $567.02 / $1,107.58	Facility		$117.00	$567.02	$1,107.58
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $64.83 / $135.38 / $525.36	Professional		$64.83	$135.38	$525.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.94 / $96.91 / $186.71	Professional		$57.94	$96.91	$186.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $64.48 / $106.37 / $180.93	Facility		$64.48	$106.37	$180.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $106.42 / $175.37	Professional		$67.00	$106.42	$175.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.01 / $100.61 / $177.40	Professional		$18.01	$100.61	$177.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $79.23 / $128.38 / $141.37	Facility		$79.23	$128.38	$141.37
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.68 / $94.68 / $96.43	Facility		$94.68	$94.68	$96.43
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.83 / $107.74 / $176.75	Professional		$64.83	$107.74	$176.75
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $367.90 / $567.35 / $1,085.27	Facility		$367.90	$567.35	$1,085.27
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $61.91 / $96.56 / $163.31	Professional		$61.91	$96.56	$163.31
United Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $648.00 / $5,793.00	Facility		$140.00	$648.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $82.74 / $102.45 / $198.54	Professional		$82.74	$102.45	$198.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $77.45	Professional		$47.86	$47.86	$77.45