Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.64 / $251.84 / $13,750.00	Facility		$118.64	$251.84	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.40 / $105.88 / $293.63	Professional		$65.40	$105.88	$293.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $119.41 / $133.88 / $243.57	Professional		$119.41	$133.88	$243.57
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $128.41 / $354.42	Facility		$55.00	$128.41	$354.42
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $119.84 / $184.00 / $687.36	Professional		$119.84	$184.00	$687.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $765.00 / $870.49	Facility		$714.97	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.71 / $147.44 / $259.91	Professional		$85.71	$147.44	$259.91
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $79.59 / $143.88 / $218.46	Facility		$79.59	$143.88	$218.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.52 / $144.61 / $221.98	Professional		$79.52	$144.61	$221.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.18 / $101.72 / $178.26	Professional		$18.18	$101.72	$178.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $120.84 / $174.20 / $188.27	Facility		$120.84	$174.20	$188.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.93 / $125.93 / $128.41	Facility		$125.93	$125.93	$128.41
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.08 / $167.73 / $230.88	Professional		$116.08	$167.73	$230.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $110.10 / $156.46 / $228.45	Professional		$110.10	$156.46	$228.45
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $546.00 / $5,793.00	Facility		$157.00	$546.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $109.20 / $151.86 / $267.45	Professional		$109.20	$151.86	$267.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $72.37 / $77.56 / $101.18	Professional		$72.37	$77.56	$101.18