Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.00 / $229.38 / $706.94	Facility		$125.00	$229.38	$706.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.63 / $121.40 / $366.22	Professional		$67.63	$121.40	$366.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.65 / $204.65 / $204.65	Professional		$204.65	$204.65	$204.65
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $128.19 / $744.18 / $1,455.83	Facility		$128.19	$744.18	$1,455.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $114.27 / $191.50 / $730.00	Professional		$114.27	$191.50	$730.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.47 / $152.47 / $152.47	Facility		$152.47	$152.47	$152.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.36 / $147.43 / $272.25	Professional		$81.36	$147.43	$272.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $140.11 / $245.31	Facility		$83.18	$140.11	$245.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $140.11 / $233.51	Professional		$83.18	$140.11	$233.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.16 / $151.02 / $269.28	Professional		$27.16	$151.02	$269.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $116.85 / $180.90 / $199.66	Facility		$116.85	$180.90	$199.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.66 / $128.19 / $136.19	Facility		$44.66	$128.19	$136.19
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.09 / $169.52 / $242.47	Professional		$114.09	$169.52	$242.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $550.49 / $761.06 / $1,455.83	Facility		$550.49	$761.06	$1,455.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $102.38 / $156.99 / $229.85	Professional		$102.38	$156.99	$229.85
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $546.00 / $5,793.00	Facility		$157.00	$546.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $110.70 / $152.19 / $281.92	Professional		$110.70	$152.19	$281.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $75.20 / $83.38 / $112.30	Professional		$75.20	$83.38	$112.30