Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $195.45 / $422.53 / $13,750.00	Facility		$195.45	$422.53	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.79 / $154.02 / $289.26	Professional		$102.79	$154.02	$289.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $233.74 / $233.74 / $233.74	Professional		$233.74	$233.74	$233.74
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $108.88 / $567.35 / $1,107.58	Facility		$108.88	$567.35	$1,107.58
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $148.18 / $323.18 / $1,245.92	Professional		$148.18	$323.18	$1,245.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.34 / $166.34 / $252.90	Facility		$166.34	$166.34	$252.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.74 / $225.50 / $445.88	Professional		$134.74	$225.50	$445.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $143.08 / $236.64 / $386.44	Facility		$143.08	$236.64	$386.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $150.77 / $242.36 / $403.01	Professional		$150.77	$242.36	$403.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.96 / $228.31 / $409.24	Professional		$40.96	$228.31	$409.24
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $186.93 / $302.00 / $336.34	Facility		$186.93	$302.00	$336.34
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $108.88 / $222.42 / $229.41	Facility		$108.88	$222.42	$229.41
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.18 / $255.79 / $420.53	Professional		$148.18	$255.79	$420.53
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 $139.99 / $226.84 / $388.55	Professional		$139.99	$226.84	$388.55
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 $195.30 / $259.01 / $482.76	Professional		$195.30	$259.01	$482.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $115.17 / $115.17 / $186.99	Professional		$115.17	$115.17	$186.99