Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $183.17 / $403.78 / $13,750.00	Facility		$183.17	$403.78	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.65 / $167.48 / $378.28	Professional		$122.65	$167.48	$378.28
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $799.01 / $799.01 / $799.01	Professional	22	$799.01	$799.01	$799.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.62 / $199.54 / $347.00	Professional		$150.62	$199.54	$347.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $138.52 / $1,104.92 / $2,206.01	Facility		$138.52	$1,104.92	$2,206.01
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $137.09 / $312.06 / $1,248.48	Professional		$137.09	$312.06	$1,248.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.86 / $421.10 / $731.00	Facility		$174.86	$421.10	$731.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.29 / $215.11 / $448.38	Professional		$126.29	$215.11	$448.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $138.50 / $231.39 / $390.65	Facility		$138.50	$231.39	$390.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $139.81 / $236.90 / $404.41	Professional		$139.81	$236.90	$404.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $200.24 / $357.19	Professional		$36.31	$200.24	$357.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $180.10 / $285.42 / $337.68	Facility		$180.10	$285.42	$337.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.37 / $226.50 / $230.33	Facility		$85.37	$226.50	$230.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.65 / $242.02 / $422.20	Professional		$138.65	$242.02	$422.20
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 $131.21 / $231.00 / $388.10	Professional		$131.21	$231.00	$388.10
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 $192.64 / $239.72 / $489.51	Professional		$192.64	$239.72	$489.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.86 / $107.86 / $187.57	Professional		$107.86	$107.86	$187.57