Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $192.15 / $400.58 / $13,750.00	Facility		$192.15	$400.58	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.45 / $165.42 / $393.61	Professional		$98.45	$165.42	$393.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $209.77 / $209.77 / $311.98	Professional		$209.77	$209.77	$311.98
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $186.83 / $1,836.95 / $3,748.81	Facility		$186.83	$1,836.95	$3,748.81
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $181.07 / $294.76 / $1,122.08	Professional		$181.07	$294.76	$1,122.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $198.44 / $765.00 / $870.49	Facility		$198.44	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.93 / $226.94 / $428.11	Professional		$133.93	$226.94	$428.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $120.28 / $213.04 / $353.55	Facility		$120.28	$213.04	$353.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.28 / $212.83 / $341.10	Professional		$120.28	$212.83	$341.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.37 / $254.08 / $447.48	Professional		$45.37	$254.08	$447.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $196.71 / $272.02 / $309.54	Facility		$196.71	$272.02	$309.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.22 / $204.76 / $211.13	Facility		$62.22	$204.76	$211.13
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.50 / $263.39 / $375.91	Professional		$180.50	$263.39	$375.91
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 $170.17 / $244.56 / $362.97	Professional		$170.17	$244.56	$362.97
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 $172.61 / $243.03 / $420.90	Professional		$172.61	$243.03	$420.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $113.39 / $127.82 / $168.64	Professional		$113.39	$127.82	$168.64