Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $195.62 / $444.06 / $809.13	Facility		$195.62	$444.06	$809.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.34 / $195.62 / $622.00	Professional		$159.34	$195.62	$622.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $232.80 / $232.80 / $232.80	Professional		$232.80	$232.80	$232.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $253.82 / $602.83 / $1,382.94	Facility		$253.82	$602.83	$1,382.94
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $206.41 / $253.66 / $1,495.20	Professional		$206.41	$253.66	$1,495.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $105.68 / $175.00 / $175.00	Facility		$105.68	$175.00	$175.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.75 / $127.75 / $220.60	Professional		$127.75	$127.75	$220.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $176.16 / $300.82 / $794.31	Facility		$176.16	$300.82	$794.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $186.31 / $306.02 / $563.52	Professional		$186.31	$306.02	$563.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.22 / $222.21 / $244.43	Professional		$22.22	$222.21	$244.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $230.09 / $283.07 / $300.24	Facility		$230.09	$283.07	$300.24
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $230.09 / $289.86 / $300.24	Professional		$230.09	$289.86	$300.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $253.82 / $325.52 / $566.14	Facility		$253.82	$325.52	$566.14
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $275.89 / $283.07 / $283.07	Facility		$275.89	$283.07	$283.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $230.27 / $246.38 / $318.85	Professional		$230.27	$246.38	$318.85
United Facility/Professional Facility Modifier Low / Median / High Price $353.74 / $424.49 / $424.49	Facility		$353.74	$424.49	$424.49
United Facility/Professional Professional Modifier Low / Median / High Price $122.38 / $132.57 / $252.52	Professional		$122.38	$132.57	$252.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $159.35 / $246.38 / $246.38	Professional		$159.35	$246.38	$246.38