Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $182.82 / $388.78 / $13,750.00	Facility		$182.82	$388.78	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.74 / $158.02 / $500.92	Professional		$92.74	$158.02	$500.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.21 / $111.21 / $111.21	Professional		$111.21	$111.21	$111.21
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $173.27 / $744.18 / $1,683.13	Facility		$173.27	$744.18	$1,683.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $167.43 / $270.32 / $1,012.88	Professional		$167.43	$270.32	$1,012.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $193.85 / $193.85 / $193.85	Facility		$193.85	$193.85	$193.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.45 / $208.25 / $385.06	Professional		$120.45	$208.25	$385.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $120.36 / $202.27 / $337.71	Facility		$120.36	$202.27	$337.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $119.00 / $202.27 / $329.47	Professional		$119.00	$202.27	$329.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.60 / $201.51 / $358.83	Professional		$36.60	$201.51	$358.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $174.00 / $257.95 / $276.70	Facility		$174.00	$257.95	$276.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.70 / $179.84 / $188.74	Facility		$57.70	$179.84	$188.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.95 / $244.85 / $340.07	Professional		$164.95	$244.85	$340.07
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 $150.68 / $221.86 / $324.93	Professional		$150.68	$221.86	$324.93
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 $157.84 / $216.31 / $393.92	Professional		$157.84	$216.31	$393.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.96 / $115.95 / $154.52	Professional		$107.96	$115.95	$154.52