Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $259.27 / $407.03 / $18,711.00	Facility		$259.27	$407.03	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.33 / $232.90 / $537.40	Professional		$140.33	$232.90	$537.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $338.73 / $338.73 / $338.73	Professional		$338.73	$338.73	$338.73
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $298.52 / $4,306.60 / $8,788.86	Facility		$298.52	$4,306.60	$8,788.86
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $246.10 / $425.49 / $1,672.81	Professional		$246.10	$425.49	$1,672.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $350.91 / $500.00 / $568.48	Facility		$350.91	$500.00	$568.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.08 / $319.35 / $623.29	Professional		$178.08	$319.35	$623.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $169.33 / $293.23 / $524.77	Facility		$169.33	$293.23	$524.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.33 / $293.23 / $508.21	Professional		$169.33	$293.23	$508.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.80 / $300.91 / $554.70	Professional		$55.80	$300.91	$554.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $250.20 / $388.60 / $445.55	Facility		$250.20	$388.60	$445.55
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.90 / $298.52 / $336.00	Facility		$111.90	$298.52	$336.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $238.39 / $353.23 / $542.61	Professional		$238.39	$353.23	$542.61
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,979.36 / $4,591.92 / $8,788.86	Facility		$2,979.36	$4,591.92	$8,788.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $212.63 / $343.95 / $524.92	Professional		$212.63	$343.95	$524.92
United Facility/Professional Facility Modifier Low / Median / High Price $472.00 / $938.00 / $4,611.00	Facility		$472.00	$938.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $252.20 / $341.01 / $613.80	Professional		$252.20	$341.01	$613.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $158.96 / $185.52 / $250.91	Professional		$158.96	$185.52	$250.91