Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $699.00 / $4,011.00 / $18,711.00	Facility		$699.00	$4,011.00	$18,711.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $268.81 / $421.44 / $614.70	Facility	52	$268.81	$421.44	$614.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $385.43 / $537.61 / $1,149.58	Professional		$385.43	$537.61	$1,149.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $403.68 / $415.63 / $855.70	Professional		$403.68	$415.63	$855.70
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,961.46 / $9,172.83 / $17,546.59	Facility		$2,961.46	$9,172.83	$17,546.59
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $4,083.38 / $6,791.96 / $6,791.96	Facility	52	$4,083.38	$6,791.96	$6,791.96
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $510.42 / $849.00 / $849.00	Facility	AS	$510.42	$849.00	$849.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $599.29 / $991.71 / $3,662.25	Professional		$599.29	$991.71	$3,662.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $3,740.43	Facility		$625.25	$761.81	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.86 / $770.21 / $1,287.61	Professional		$457.86	$770.21	$1,287.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $467.76 / $944.38 / $3,280.24	Facility		$467.76	$944.38	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $436.41 / $904.06 / $2,824.57	Professional		$436.41	$904.06	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.69 / $355.74 / $939.74	Professional		$71.69	$355.74	$939.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $622.60 / $828.79 / $853.58	Facility		$622.60	$828.79	$853.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $568.05 / $582.22 / $2,961.46	Facility		$568.05	$582.22	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $646.87 / $927.96 / $1,155.65	Professional		$646.87	$927.96	$1,155.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,948.17 / $9,167.59 / $17,546.59	Facility		$5,948.17	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $579.35 / $831.71 / $1,107.92	Professional		$579.35	$831.71	$1,107.92
United Facility/Professional Facility Modifier Low / Median / High Price $1,547.00 / $2,408.00 / $10,522.00	Facility		$1,547.00	$2,408.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $531.91 / $688.46 / $1,215.57	Professional		$531.91	$688.46	$1,215.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $352.82 / $352.82 / $455.16	Professional		$352.82	$352.82	$455.16