Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $193.39 / $382.46 / $13,750.00	Facility		$193.39	$382.46	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.64 / $162.53 / $367.10	Professional		$110.64	$162.53	$367.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.44 / $238.09 / $293.70	Professional		$163.44	$238.09	$293.70
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $90.09 / $854.53 / $1,739.05	Facility		$90.09	$854.53	$1,739.05
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $192.08 / $333.61 / $1,203.59	Professional		$192.08	$333.61	$1,203.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.36 / $116.36 / $193.85	Facility		$116.36	$116.36	$193.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.68 / $280.60 / $489.58	Professional		$167.68	$280.60	$489.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $132.37 / $241.80 / $389.16	Facility		$132.37	$241.80	$389.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $132.83 / $238.70 / $355.72	Professional		$132.83	$238.70	$355.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.97 / $278.79 / $453.80	Professional		$42.97	$278.79	$453.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $193.92 / $271.35 / $327.63	Facility		$193.92	$271.35	$327.63
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $90.09 / $219.25 / $223.47	Facility		$90.09	$219.25	$223.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $192.08 / $279.45 / $409.64	Professional		$192.08	$279.45	$409.64
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $663.37 / $908.60 / $1,739.05	Facility		$663.37	$908.60	$1,739.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $173.94 / $252.36 / $378.49	Professional		$173.94	$252.36	$378.49
United Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $910.00 / $5,793.00	Facility		$190.00	$910.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $190.00 / $317.33 / $468.26	Professional		$190.00	$317.33	$468.26