Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $211.71 / $461.80 / $13,750.00	Facility		$211.71	$461.80	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.48 / $175.56 / $427.43	Professional		$107.48	$175.56	$427.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $202.87 / $281.02 / $462.19	Professional		$202.87	$281.02	$462.19
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $232.79 / $1,836.95 / $3,748.81	Facility		$232.79	$1,836.95	$3,748.81
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $198.40 / $338.67 / $1,307.28	Professional		$198.40	$338.67	$1,307.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $241.34 / $765.00 / $870.49	Facility		$241.34	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.12 / $249.81 / $498.36	Professional		$147.12	$249.81	$498.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $133.25 / $243.87 / $405.86	Facility		$133.25	$243.87	$405.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $133.25 / $241.43 / $390.68	Professional		$133.25	$241.43	$390.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.53 / $254.08 / $447.48	Professional		$45.53	$254.08	$447.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $207.80 / $312.89 / $359.12	Facility		$207.80	$312.89	$359.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.52 / $240.54 / $244.95	Facility		$77.52	$240.54	$244.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $196.39 / $289.44 / $440.09	Professional		$196.39	$289.44	$440.09
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 $185.78 / $284.33 / $422.42	Professional		$185.78	$284.33	$422.42
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 $207.46 / $283.62 / $484.11	Professional		$207.46	$283.62	$484.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $122.95 / $148.25 / $196.75	Professional		$122.95	$148.25	$196.75