Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.09 / $543.41 / $13,750.00	Facility		$137.09	$543.41	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.09 / $196.82 / $487.23	Professional		$69.09	$196.82	$487.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $298.41 / $298.41 / $434.05	Professional		$298.41	$298.41	$434.05
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $393.20 / $3,344.18 / $11,500.00	Facility		$393.20	$3,344.18	$11,500.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $120.09 / $497.70 / $2,062.96	Professional		$120.09	$497.70	$2,062.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.97 / $714.97 / $947.00	Facility		$309.97	$714.97	$947.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.56 / $247.04 / $789.53	Professional		$97.56	$247.04	$789.53
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $103.85 / $275.94 / $740.02	Facility		$103.85	$275.94	$740.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $98.64 / $228.41 / $579.52	Professional		$98.64	$228.41	$579.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.91 / $439.40 / $742.38	Professional		$70.91	$439.40	$742.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $177.10 / $448.80 / $562.79	Facility		$177.10	$448.80	$562.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $258.89 / $383.88 / $393.20	Facility		$258.89	$383.88	$393.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.48 / $315.45 / $733.69	Professional		$123.48	$315.45	$733.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,168.55 / $3,344.18 / $6,397.05	Facility		$2,168.55	$3,344.18	$6,397.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $125.63 / $284.16 / $637.98	Professional		$125.63	$284.16	$637.98
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $1,120.00 / $6,857.00	Facility		$650.00	$1,120.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $258.95 / $438.59 / $805.59	Professional		$258.95	$438.59	$805.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $80.61 / $224.99 / $312.26	Professional		$80.61	$224.99	$312.26