Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.45 / $231.21 / $524.00	Facility		$77.45	$231.21	$524.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.47 / $120.87 / $224.19	Professional		$45.47	$120.87	$224.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.00 / $86.00 / $86.00	Professional		$86.00	$86.00	$86.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $209.32 / $521.29 / $820.82	Facility		$209.32	$521.29	$820.82
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $72.18 / $247.95 / $855.04	Professional		$72.18	$247.95	$855.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.80 / $134.05 / $365.70	Professional		$54.80	$134.05	$365.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $49.59 / $116.22 / $302.44	Facility		$49.59	$116.22	$302.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.00 / $110.32 / $290.26	Professional		$49.00	$110.32	$290.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.71 / $216.54 / $365.19	Professional		$36.71	$216.54	$365.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $99.89 / $226.46 / $260.63	Facility		$99.89	$226.46	$260.63
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.77 / $177.77 / $179.84	Facility		$177.77	$177.77	$179.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $162.41 / $339.16	Professional		$75.86	$162.41	$339.16
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $425.63 / $607.41 / $1,161.91	Facility		$425.63	$607.41	$1,161.91
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $65.67 / $155.90 / $292.82	Professional		$65.67	$155.90	$292.82
United Facility/Professional Facility Modifier Low / Median / High Price $598.91 / $781.50 / $1,205.31	Facility		$598.91	$781.50	$1,205.31
United Facility/Professional Professional Modifier Low / Median / High Price $128.69 / $210.08 / $378.48	Professional		$128.69	$210.08	$378.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $47.04 / $104.08 / $143.72	Professional		$47.04	$104.08	$143.72