Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.93 / $1,343.65 / $16,508.00	Facility		$170.93	$1,343.65	$16,508.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.81 / $515.26 / $1,121.50	Professional		$149.81	$515.26	$1,121.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $240.76 / $240.76 / $240.76	Professional		$240.76	$240.76	$240.76
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $938.28 / $2,332.34	Facility		$55.00	$938.28	$2,332.34
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $3,498.51 / $3,498.51 / $3,498.51	Facility	50	$3,498.51	$3,498.51	$3,498.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $246.64 / $1,075.03 / $4,275.92	Professional		$246.64	$1,075.03	$4,275.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.85 / $441.84 / $1,637.46	Professional		$176.85	$441.84	$1,637.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $192.00 / $495.38 / $1,569.01	Facility		$192.00	$495.38	$1,569.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $196.73 / $495.38 / $1,556.99	Professional		$196.73	$495.38	$1,556.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $151.01 / $900.15 / $1,523.97	Professional		$151.01	$900.15	$1,523.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $302.66 / $1,101.26 / $1,170.49	Facility		$302.66	$1,101.26	$1,170.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $798.38 / $798.38 / $834.88	Facility		$798.38	$798.38	$834.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $242.94 / $609.48 / $1,584.70	Professional		$242.94	$609.48	$1,584.70
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $246.64 / $507.24 / $1,362.67	Professional		$246.64	$507.24	$1,362.67
United Facility/Professional Facility Modifier Low / Median / High Price $414.00 / $666.00 / $6,216.00	Facility		$414.00	$666.00	$6,216.00
United Facility/Professional Professional Modifier Low / Median / High Price $634.13 / $1,061.55 / $1,720.52	Professional		$634.13	$1,061.55	$1,720.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $138.46 / $138.46 / $641.61	Professional		$138.46	$138.46	$641.61