Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $312.80 / $891.18 / $9,703.00	Facility		$312.80	$891.18	$9,703.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $156.06 / $251.07 / $679.51	Professional		$156.06	$251.07	$679.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.07 / $253.78 / $584.40	Professional		$114.07	$253.78	$584.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $224.92 / $1,130.00 / $2,206.01	Facility		$224.92	$1,130.00	$2,206.01
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $238.76 / $538.79 / $2,106.71	Professional		$238.76	$538.79	$2,106.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $292.77 / $292.77 / $445.13	Facility		$292.77	$292.77	$445.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.99 / $372.35 / $757.67	Professional		$216.99	$372.35	$757.67
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $233.21 / $377.29 / $649.79	Facility		$233.21	$377.29	$649.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $233.37 / $391.50 / $668.62	Professional		$233.37	$391.50	$668.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.96 / $225.07 / $617.11	Professional		$34.96	$225.07	$617.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $281.01 / $463.30 / $571.51	Facility		$281.01	$463.30	$571.51
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $150.57 / $385.05 / $389.82	Facility		$150.57	$385.05	$389.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $238.76 / $412.29 / $711.81	Professional		$238.76	$412.29	$711.81
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $732.75 / $1,129.34 / $2,161.55	Facility		$732.75	$1,129.34	$2,161.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $228.23 / $392.70 / $660.22	Professional		$228.23	$392.70	$660.22
United Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $414.00 / $5,793.00	Facility		$140.00	$414.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $324.66 / $384.56 / $811.31	Professional		$324.66	$384.56	$811.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $184.48 / $184.48 / $315.89	Professional		$184.48	$184.48	$315.89