Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $340.22 / $1,733.00 / $13,809.00	Facility		$340.22	$1,733.00	$13,809.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $265.48 / $753.19 / $1,863.02	Professional		$265.48	$753.19	$1,863.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $387.90 / $387.90 / $463.22	Professional		$387.90	$387.90	$463.22
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,705.02 / $1,705.02 / $8,980.00	Facility		$1,705.02	$1,705.02	$8,980.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $435.92 / $1,490.29 / $7,304.82	Professional		$435.92	$1,490.29	$7,304.82
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $579.67 / $1,475.29 / $2,256.44	Professional	50	$579.67	$1,475.29	$2,256.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $318.24 / $790.94 / $2,401.02	Professional		$318.24	$790.94	$2,401.02
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $348.48 / $791.97 / $2,464.15	Facility		$348.48	$791.97	$2,464.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $358.02 / $726.02 / $2,464.15	Professional		$358.02	$726.02	$2,464.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $215.92 / $1,273.30 / $2,152.30	Professional		$215.92	$1,273.30	$2,152.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $542.34 / $1,552.88 / $1,753.04	Facility		$542.34	$1,552.88	$1,753.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,123.31 / $1,123.31 / $1,167.83	Facility		$1,123.31	$1,123.31	$1,167.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $440.51 / $1,105.16 / $2,229.65	Professional		$440.51	$1,105.16	$2,229.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $447.23 / $919.77 / $1,998.25	Professional		$447.23	$919.77	$1,998.25
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 $957.45 / $1,807.44 / $2,466.05	Professional		$957.45	$1,807.44	$2,466.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $250.39 / $250.39 / $897.97	Professional		$250.39	$250.39	$897.97