Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $183.04 / $295.54 / $12,214.00	Facility		$183.04	$295.54	$12,214.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.62 / $133.34 / $289.97	Professional		$91.62	$133.34	$289.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.74 / $257.74 / $257.74	Professional		$257.74	$257.74	$257.74
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $118.22 / $2,141.39 / $4,357.93	Facility		$118.22	$2,141.39	$4,357.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $177.17 / $324.55 / $1,152.96	Professional		$177.17	$324.55	$1,152.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.16 / $147.16 / $245.18	Facility		$147.16	$147.16	$245.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.81 / $282.20 / $474.64	Professional		$129.81	$282.20	$474.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $119.11 / $202.97 / $505.31	Facility		$119.11	$202.97	$505.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.50 / $199.08 / $302.64	Professional		$123.50	$199.08	$302.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $222.41 / $364.68	Professional		$34.79	$222.41	$364.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $147.49 / $236.70 / $314.23	Facility		$147.49	$236.70	$314.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $118.22 / $213.36 / $214.33	Facility		$118.22	$213.36	$214.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.22 / $277.19 / $390.91	Professional		$184.22	$277.19	$390.91
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 $169.94 / $252.56 / $358.00	Professional		$169.94	$252.56	$358.00
United Facility/Professional Facility Modifier Low / Median / High Price $648.00 / $789.56 / $4,611.00	Facility		$648.00	$789.56	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $140.22 / $257.95 / $452.82	Professional		$140.22	$257.95	$452.82