Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.83 / $1,710.00 / $13,750.00	Facility		$162.83	$1,710.00	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.73 / $187.96 / $450.69	Professional		$78.73	$187.96	$450.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.67 / $41.67 / $41.67	Professional		$41.67	$41.67	$41.67
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $525.10 / $1,959.77 / $11,500.00	Facility		$525.10	$1,959.77	$11,500.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $158.80 / $346.36 / $1,410.78	Professional		$158.80	$346.36	$1,410.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $466.83 / $568.48 / $880.53	Facility		$466.83	$568.48	$880.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.51 / $241.08 / $495.86	Professional		$106.51	$241.08	$495.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $105.27 / $249.61 / $652.97	Facility		$105.27	$249.61	$652.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $105.27 / $239.86 / $556.66	Professional		$105.27	$239.86	$556.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.62 / $344.14 / $606.24	Professional		$60.62	$344.14	$606.24
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $189.97 / $349.74 / $384.58	Facility		$189.97	$349.74	$384.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $232.84 / $238.22 / $715.32	Facility		$232.84	$238.22	$715.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.50 / $254.09 / $445.92	Professional		$149.50	$254.09	$445.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,270.82 / $1,958.65 / $3,748.81	Facility		$1,270.82	$1,958.65	$3,748.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $144.87 / $237.47 / $432.42	Professional		$144.87	$237.47	$432.42
United Facility/Professional Facility Modifier Low / Median / High Price $472.00 / $938.00 / $4,611.00	Facility		$472.00	$938.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $224.46 / $294.26 / $516.54	Professional		$224.46	$294.26	$516.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $95.91 / $155.15 / $206.80	Professional		$95.91	$155.15	$206.80