Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $246.07 / $558.58 / $583.19	Facility		$246.07	$558.58	$583.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.60 / $246.07 / $425.70	Professional		$125.60	$246.07	$425.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $378.65 / $378.65 / $378.65	Professional		$378.65	$378.65	$378.65
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $331.57 / $757.31 / $1,976.32	Facility		$331.57	$757.31	$1,976.32
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $284.26 / $350.99 / $2,200.21	Professional		$284.26	$350.99	$2,200.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $296.00 / $296.00 / $301.92	Facility		$296.00	$296.00	$301.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.08 / $216.08 / $296.00	Professional		$216.08	$216.08	$296.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $238.42 / $402.95 / $1,037.61	Facility		$238.42	$402.95	$1,037.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $238.68 / $405.86 / $803.50	Professional		$238.68	$405.86	$803.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $261.25 / $290.27 / $319.30	Professional		$261.25	$290.27	$319.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $300.56 / $369.78 / $427.28	Facility		$300.56	$369.78	$427.28
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $300.81 / $378.65 / $427.28	Professional		$300.81	$378.65	$427.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $331.57 / $425.25 / $739.56	Facility		$331.57	$425.25	$739.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.42 / $245.42 / $245.42	Professional		$245.42	$245.42	$245.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $360.41 / $369.78 / $369.78	Facility		$360.41	$369.78	$369.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $300.81 / $321.85 / $416.52	Professional		$300.81	$321.85	$416.52
United Facility/Professional Professional Modifier Low / Median / High Price $183.80 / $284.62 / $360.41	Professional		$183.80	$284.62	$360.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $157.16 / $157.16 / $321.85	Professional		$157.16	$157.16	$321.85