Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.27 / $228.43 / $422.48	Professional		$189.27	$228.43	$422.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $315.10 / $315.10 / $315.10	Professional		$315.10	$315.10	$315.10
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,779.10 / $1,779.10	Facility		$100.00	$1,779.10	$1,779.10
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $227.12 / $293.85 / $408.28	Professional		$227.12	$293.85	$408.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.45 / $263.45 / $325.44	Facility		$263.45	$263.45	$325.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.93 / $223.93 / $438.75	Professional		$223.93	$223.93	$438.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $378.53 / $378.53 / $378.53	Facility		$378.53	$378.53	$378.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $378.53 / $378.53 / $378.53	Professional		$378.53	$378.53	$378.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $306.00 / $336.60	Professional		$75.00	$306.00	$336.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $349.96 / $378.65 / $406.92	Facility		$349.96	$378.65	$406.92
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $340.68 / $378.53 / $388.84	Professional		$340.68	$378.53	$388.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.27 / $332.66 / $422.62	Facility		$33.27	$332.66	$422.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.24 / $356.47 / $422.62	Professional		$31.24	$356.47	$422.62
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $367.50 / $367.50 / $367.50	Facility		$367.50	$367.50	$367.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $26.96 / $26.96 / $32.83	Professional		$26.96	$26.96	$32.83
United Facility/Professional Professional Modifier Low / Median / High Price $181.58 / $188.58 / $362.58	Professional		$181.58	$188.58	$362.58