Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.55 / $244.72 / $13,750.00	Facility		$65.55	$244.72	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.99 / $113.09 / $251.67	Professional		$46.99	$113.09	$251.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $183.74 / $238.04 / $271.93	Professional		$183.74	$238.04	$271.93
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $144.07 / $1,300.00 / $3,421.76	Facility		$144.07	$1,300.00	$3,421.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $77.01 / $235.58 / $946.80	Professional		$77.01	$235.58	$946.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.66 / $466.83 / $636.00	Facility		$135.66	$466.83	$636.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.47 / $144.94 / $367.04	Professional		$67.47	$144.94	$367.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $72.90 / $147.41 / $420.93	Facility		$72.90	$147.41	$420.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.58 / $137.62 / $302.57	Professional		$67.58	$137.62	$302.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.74 / $218.43 / $371.34	Professional		$35.74	$218.43	$371.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $108.00 / $235.17 / $257.95	Facility		$108.00	$235.17	$257.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $106.12 / $175.95 / $176.22	Facility		$106.12	$175.95	$176.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.18 / $168.44 / $334.83	Professional		$79.18	$168.44	$334.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,679.53 / $2,590.05 / $4,954.47	Facility		$1,679.53	$2,590.05	$4,954.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $80.05 / $153.83 / $292.41	Professional		$80.05	$153.83	$292.41
United Facility/Professional Facility Modifier Low / Median / High Price $887.00 / $3,160.60 / $4,911.00	Facility		$887.00	$3,160.60	$4,911.00
United Facility/Professional Professional Modifier Low / Median / High Price $127.04 / $207.90 / $367.64	Professional		$127.04	$207.90	$367.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.49 / $107.11 / $146.99	Professional		$51.49	$107.11	$146.99