Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $222.34 / $1,686.00 / $6,470.00	Facility		$222.34	$1,686.00	$6,470.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.09 / $180.22 / $387.57	Professional		$136.09	$180.22	$387.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $296.24 / $296.24 / $296.24	Professional		$296.24	$296.24	$296.24
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $627.76 / $1,780.27 / $11,500.00	Facility		$627.76	$1,780.27	$11,500.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $224.00 / $360.58 / $1,213.35	Professional		$224.00	$360.58	$1,213.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $787.12 / $787.12 / $787.12	Facility		$787.12	$787.12	$787.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.81 / $309.02 / $490.46	Professional		$198.81	$309.02	$490.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $166.78 / $325.20 / $552.04	Facility		$166.78	$325.20	$552.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $189.48 / $307.72 / $453.18	Professional		$189.48	$307.72	$453.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.44 / $212.51 / $348.27	Professional		$34.44	$212.51	$348.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $227.23 / $314.23 / $336.60	Facility		$227.23	$314.23	$336.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $224.24 / $224.24 / $224.39	Facility		$224.24	$224.24	$224.39
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $219.21 / $317.32 / $411.31	Professional		$219.21	$317.32	$411.31
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,279.54 / $1,780.27 / $3,405.45	Facility		$1,279.54	$1,780.27	$3,405.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $217.55 / $288.95 / $381.26	Professional		$217.55	$288.95	$381.26
United Facility/Professional Facility Modifier Low / Median / High Price $648.00 / $1,875.00 / $4,911.00	Facility		$648.00	$1,875.00	$4,911.00
United Facility/Professional Professional Modifier Low / Median / High Price $209.44 / $274.33 / $471.25	Professional		$209.44	$274.33	$471.25