Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.00 / $389.33 / $854.72	Facility		$57.00	$389.33	$854.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.82 / $91.52 / $254.73	Professional		$51.82	$91.52	$254.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.91 / $113.91 / $178.49	Professional		$113.91	$113.91	$178.49
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $108.27 / $436.62 / $987.53	Facility		$108.27	$436.62	$987.53
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $73.84 / $156.08 / $621.67	Professional		$73.84	$156.08	$621.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.36 / $123.36 / $123.36	Facility		$123.36	$123.36	$123.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.44 / $109.00 / $223.92	Professional		$64.44	$109.00	$223.92
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $69.23 / $120.02 / $215.23	Facility		$69.23	$120.02	$215.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.23 / $118.83 / $204.82	Professional		$69.23	$118.83	$204.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.95 / $151.02 / $269.28	Professional		$26.95	$151.02	$269.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $100.30 / $156.49 / $170.18	Facility		$100.30	$156.49	$170.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.38 / $108.27 / $116.08	Facility		$36.38	$108.27	$116.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.98 / $116.08 / $208.38	Professional		$69.98	$116.08	$208.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $289.56 / $446.53 / $854.16	Facility		$289.56	$446.53	$854.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $63.53 / $110.42 / $196.40	Professional		$63.53	$110.42	$196.40
United Facility/Professional Facility Modifier Low / Median / High Price $151.00 / $648.00 / $5,793.00	Facility		$151.00	$648.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $99.33 / $133.97 / $237.51	Professional		$99.33	$133.97	$237.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.85 / $70.95 / $94.94	Professional		$42.85	$70.95	$94.94