Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.25 / $363.98 / $9,703.00	Facility		$137.25	$363.98	$9,703.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.34 / $146.46 / $349.09	Professional		$76.34	$146.46	$349.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $186.04 / $186.04 / $186.04	Professional		$186.04	$186.04	$186.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $117.51 / $2,141.39 / $4,357.93	Facility		$117.51	$2,141.39	$4,357.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $137.02 / $301.04 / $1,138.48	Professional		$137.02	$301.04	$1,138.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $143.47 / $143.47 / $239.04	Facility		$143.47	$143.47	$239.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.71 / $222.44 / $468.42	Professional		$121.71	$222.44	$468.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $112.22 / $185.32 / $500.62	Facility		$112.22	$185.32	$500.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.22 / $183.66 / $318.74	Professional		$112.22	$183.66	$318.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.76 / $222.41 / $364.68	Professional		$34.76	$222.41	$364.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $140.40 / $248.36 / $310.20	Facility		$140.40	$248.36	$310.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.51 / $211.59 / $212.91	Facility		$117.51	$211.59	$212.91
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $211.59 / $387.86	Professional		$134.90	$211.59	$387.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,477.31 / $2,250.40 / $4,357.93	Facility		$1,477.31	$2,250.40	$4,357.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $120.09 / $212.08 / $358.36	Professional		$120.09	$212.08	$358.36
United Facility/Professional Facility Modifier Low / Median / High Price $591.00 / $1,106.00 / $4,911.00	Facility		$591.00	$1,106.00	$4,911.00
United Facility/Professional Professional Modifier Low / Median / High Price $176.73 / $304.26 / $448.97	Professional		$176.73	$304.26	$448.97