Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.25 / $349.71 / $13,750.00	Facility		$151.25	$349.71	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.18 / $108.75 / $259.24	Professional		$76.18	$108.75	$259.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.26 / $141.82 / $159.01	Professional		$102.26	$141.82	$159.01
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $171.23 / $370.89 / $12,000.00	Facility		$171.23	$370.89	$12,000.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $117.65 / $247.31 / $937.28	Professional		$117.65	$247.31	$937.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $421.10 / $731.00 / $731.00	Facility		$421.10	$731.00	$731.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.50 / $177.39 / $334.69	Professional		$103.50	$177.39	$334.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $189.02 / $307.60	Facility		$117.49	$189.02	$307.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.00 / $192.00 / $324.42	Professional		$118.00	$192.00	$324.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.11 / $150.05 / $267.18	Professional		$27.11	$150.05	$267.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $140.79 / $231.94 / $254.60	Facility		$140.79	$231.94	$254.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $171.23 / $171.23 / $173.66	Facility		$171.23	$171.23	$173.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.72 / $196.92 / $318.39	Professional		$115.72	$196.92	$318.39
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $198.10 / $198.10 / $249.58	Facility		$198.10	$198.10	$249.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $111.34 / $174.64 / $294.12	Professional		$111.34	$174.64	$294.12
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 $153.35 / $194.49 / $368.82	Professional		$153.35	$194.49	$368.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.95 / $85.95 / $138.04	Professional		$85.95	$85.95	$138.04