Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.46 / $108.38 / $254.89	Facility		$50.46	$108.38	$254.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.90 / $158.47 / $308.95	Professional		$109.90	$158.47	$308.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.50 / $126.30 / $195.50	Professional		$52.50	$126.30	$195.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $109.01 / $174.42 / $570.73	Facility		$109.01	$174.42	$570.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $147.10 / $297.64 / $1,080.23	Professional		$147.10	$297.64	$1,080.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $205.39 / $334.78 / $437.00	Facility		$205.39	$334.78	$437.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.99 / $267.22 / $408.21	Professional		$142.99	$267.22	$408.21
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $130.51 / $265.05 / $357.20	Facility		$130.51	$265.05	$357.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $130.51 / $267.58 / $357.20	Professional		$130.51	$267.58	$357.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $65.00	Professional		$45.00	$50.00	$65.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $175.78 / $248.43 / $251.92	Facility		$175.78	$248.43	$251.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $170.33 / $170.33 / $171.83	Facility		$170.33	$170.33	$171.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.09 / $295.12 / $352.42	Professional		$194.09	$295.12	$352.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $109.01 / $130.82 / $189.10	Facility		$109.01	$130.82	$189.10
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $173.71 / $257.56 / $351.15	Professional		$173.71	$257.56	$351.15
United Facility/Professional Professional Modifier Low / Median / High Price $144.80 / $182.11 / $357.21	Professional		$144.80	$182.11	$357.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $126.52 / $126.52 / $126.52	Professional		$126.52	$126.52	$126.52