Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $396.43 / $915.49 / $12,214.00	Facility		$396.43	$915.49	$12,214.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.27 / $314.99 / $622.82	Professional		$195.27	$314.99	$622.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.69 / $146.69 / $146.69	Professional		$146.69	$146.69	$146.69
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 $302.33 / $692.78 / $2,702.96	Professional		$302.33	$692.78	$2,702.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $334.00 / $334.00 / $507.81	Facility		$334.00	$334.00	$507.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.70 / $472.17 / $970.26	Professional		$274.70	$472.17	$970.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $282.14 / $464.76 / $839.86	Facility		$282.14	$464.76	$839.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $302.50 / $495.23 / $880.93	Professional		$302.50	$495.23	$880.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.96 / $285.80 / $784.55	Professional		$34.96	$285.80	$784.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $349.52 / $602.00 / $732.31	Facility		$349.52	$602.00	$732.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $150.57 / $493.77 / $499.50	Facility		$150.57	$493.77	$499.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.68 / $526.72 / $915.44	Professional		$302.68	$526.72	$915.44
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 $289.20 / $503.58 / $845.98	Professional		$289.20	$503.58	$845.98
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 $408.99 / $528.32 / $1,041.19	Professional		$408.99	$528.32	$1,041.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $233.33 / $233.33 / $404.60	Professional		$233.33	$233.33	$404.60