Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $148.66 / $2,121.69 / $3,818.00	Facility		$148.66	$2,121.69	$3,818.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $45.05 / $90.48 / $1,566.28	Facility	52	$45.05	$90.48	$1,566.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.04 / $118.50 / $315.43	Professional		$66.04	$118.50	$315.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.68 / $272.32 / $272.32	Professional		$86.68	$272.32	$272.32
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $328.49 / $1,992.71 / $3,814.01	Facility		$328.49	$1,992.71	$3,814.01
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $148.81 / $262.79 / $262.79	Facility	52	$148.81	$262.79	$262.79
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $127.42 / $256.58 / $1,001.20	Professional		$127.42	$256.58	$1,001.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $536.85 / $536.85 / $894.39	Facility		$536.85	$536.85	$894.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.17 / $212.99 / $406.69	Professional		$116.17	$212.99	$406.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $113.90 / $196.20 / $635.54	Facility		$113.90	$196.20	$635.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.02 / $190.98 / $427.15	Professional		$112.02	$190.98	$427.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.91 / $167.04 / $273.41	Professional		$25.91	$167.04	$273.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $141.05 / $440.02 / $697.02	Facility		$141.05	$440.02	$697.02
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $184.17 / $186.18 / $331.34	Facility		$184.17	$186.18	$331.34
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $124.14 / $195.93 / $348.01	Professional		$124.14	$195.93	$348.01
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,454.88 / $1,992.71 / $3,814.01	Facility		$1,454.88	$1,992.71	$3,814.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $117.39 / $189.88 / $311.92	Professional		$117.39	$189.88	$311.92
United Facility/Professional Facility Modifier Low / Median / High Price $591.00 / $1,106.00 / $4,911.00	Facility		$591.00	$1,106.00	$4,911.00
United Facility/Professional Professional Modifier Low / Median / High Price $161.47 / $266.30 / $392.96	Professional		$161.47	$266.30	$392.96