Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.68 / $196.76 / $223.94	Facility		$86.68	$196.76	$223.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.71 / $77.05 / $314.00	Professional		$63.71	$77.05	$314.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.44 / $13.44 / $13.44	Professional		$13.44	$13.44	$13.44
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $112.47 / $251.80 / $587.62	Facility		$112.47	$251.80	$587.62
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $87.11 / $111.09 / $702.53	Professional		$87.11	$111.09	$702.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.33 / $88.85 / $88.85	Facility		$84.33	$88.85	$88.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.86 / $64.86 / $88.85	Professional		$64.86	$64.86	$88.85
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $69.61 / $128.44 / $317.81	Facility		$69.61	$128.44	$317.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.69 / $127.80 / $235.01	Professional		$69.69	$127.80	$235.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.93 / $121.04 / $136.33	Professional		$108.93	$121.04	$136.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $101.95 / $115.60 / $128.44	Facility		$101.95	$115.60	$128.44
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $113.76 / $115.60 / $128.44	Professional		$113.76	$115.60	$128.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.47 / $144.24 / $250.86	Facility		$112.47	$144.24	$250.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $122.25 / $125.43 / $125.43	Facility		$122.25	$125.43	$125.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $102.04 / $109.17 / $141.28	Professional		$102.04	$109.17	$141.28
United Facility/Professional Professional Modifier Low / Median / High Price $51.17 / $63.97 / $105.60	Professional		$51.17	$63.97	$105.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $67.73 / $84.83 / $84.83	Professional		$67.73	$84.83	$84.83