Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.98 / $404.00 / $3,568.00	Facility		$57.98	$404.00	$3,568.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.52 / $107.33 / $255.24	Professional		$48.52	$107.33	$255.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $142.68 / $142.68 / $142.68	Professional		$142.68	$142.68	$142.68
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $249.58 / $567.02 / $1,107.58	Facility		$249.58	$567.02	$1,107.58
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $64.34 / $173.78 / $825.15	Professional		$64.34	$173.78	$825.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.26 / $115.83 / $250.91	Professional		$56.26	$115.83	$250.91
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $62.40 / $132.18 / $283.82	Facility		$62.40	$132.18	$283.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.15 / $130.56 / $254.66	Professional		$64.15	$130.56	$254.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.01 / $150.05 / $267.18	Professional		$27.01	$150.05	$267.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $85.09 / $170.18 / $190.40	Facility		$85.09	$170.18	$190.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $126.84 / $126.84 / $129.79	Facility		$126.84	$126.84	$129.79
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.84 / $127.57 / $235.88	Professional		$63.84	$127.57	$235.88
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 $61.45 / $118.66 / $228.20	Professional		$61.45	$118.66	$228.20
United Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $588.00 / $5,793.00	Facility		$140.00	$588.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $110.94 / $146.54 / $273.23	Professional		$110.94	$146.54	$273.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.17 / $46.17 / $104.58	Professional		$46.17	$46.17	$104.58