Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $157.44 / $307.98 / $890.70	Facility		$157.44	$307.98	$890.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.25 / $157.44 / $470.28	Professional		$128.25	$157.44	$470.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $300.00 / $300.00 / $300.00	Professional		$300.00	$300.00	$300.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $204.29 / $485.27 / $1,113.14	Facility		$204.29	$485.27	$1,113.14
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $166.14 / $204.17 / $1,203.42	Professional		$166.14	$204.17	$1,203.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.55 / $152.55 / $153.72	Facility		$152.55	$152.55	$153.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.36 / $111.36 / $153.72	Professional		$111.36	$111.36	$153.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $138.44 / $247.13 / $611.25	Facility		$138.44	$247.13	$611.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $245.94 / $453.47	Professional		$141.60	$245.94	$453.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $233.30 / $233.30	Professional		$60.00	$233.30	$233.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $185.20 / $227.83 / $241.65	Facility		$185.20	$227.83	$241.65
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $209.97 / $233.30 / $256.63	Professional		$209.97	$233.30	$256.63
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.29 / $262.00 / $455.66	Facility		$204.29	$262.00	$455.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $222.06 / $227.83 / $227.83	Facility		$222.06	$227.83	$227.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $185.35 / $198.31 / $256.63	Professional		$185.35	$198.31	$256.63
United Facility/Professional Professional Modifier Low / Median / High Price $98.50 / $110.86 / $203.25	Professional		$98.50	$110.86	$203.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.26 / $83.26 / $114.05	Professional		$83.26	$83.26	$114.05