Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $614.88 / $1,344.71 / $14,960.00	Facility		$614.88	$1,344.71	$14,960.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $277.06 / $518.37 / $1,077.63	Professional		$277.06	$518.37	$1,077.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $201.15 / $221.56 / $486.93	Professional		$201.15	$221.56	$486.93
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $680.93 / $1,848.40 / $3,936.16	Facility		$680.93	$1,848.40	$3,936.16
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $469.92 / $965.92 / $3,692.48	Professional		$469.92	$965.92	$3,692.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $511.44 / $777.59 / $1,110.00	Facility		$511.44	$777.59	$1,110.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $424.72 / $712.05 / $1,317.40	Professional		$424.72	$712.05	$1,317.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $447.33 / $740.00 / $1,203.79	Facility		$447.33	$740.00	$1,203.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $456.48 / $765.30 / $1,213.21	Professional		$456.48	$765.30	$1,213.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $90.09 / $518.32 / $1,136.07	Professional		$90.09	$518.32	$1,136.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $529.74 / $913.51 / $998.30	Facility		$529.74	$913.51	$998.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $236.51 / $671.35 / $680.93	Facility		$236.51	$671.35	$680.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $469.92 / $788.54 / $1,248.17	Professional		$469.92	$788.54	$1,248.17
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,154.13 / $1,778.80 / $3,404.60	Facility		$1,154.13	$1,778.80	$3,404.60
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $452.30 / $684.68 / $1,153.26	Professional		$452.30	$684.68	$1,153.26
United Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $588.00 / $5,793.00	Facility		$140.00	$588.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $617.91 / $768.41 / $1,440.54	Professional		$617.91	$768.41	$1,440.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $357.64 / $357.64 / $545.48	Professional		$357.64	$357.64	$545.48