Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $160.85 / $380.58 / $14,464.32	Facility		$160.85	$380.58	$14,464.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $135.44 / $336.31	Professional		$77.84	$135.44	$336.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.44 / $309.83 / $309.83	Professional		$134.44	$309.83	$309.83
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $311.31 / $567.02 / $1,107.58	Facility		$311.31	$567.02	$1,107.58
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $123.14 / $285.70 / $1,110.16	Professional		$123.14	$285.70	$1,110.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.19 / $197.19 / $398.62	Professional		$112.19	$197.19	$398.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $127.00 / $201.15 / $366.81	Facility		$127.00	$201.15	$366.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.72 / $209.79 / $366.81	Professional		$127.72	$209.79	$366.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.89 / $174.43 / $324.46	Professional		$31.89	$174.43	$324.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $152.81 / $265.27 / $300.16	Facility		$152.81	$265.27	$300.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $198.41 / $198.41 / $204.74	Facility		$198.41	$198.41	$204.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.14 / $213.57 / $370.07	Professional		$123.14	$213.57	$370.07
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 $115.96 / $202.36 / $346.75	Professional		$115.96	$202.36	$346.75
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 $173.46 / $214.76 / $428.68	Professional		$173.46	$214.76	$428.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $96.44 / $96.44 / $167.48	Professional		$96.44	$96.44	$167.48