Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $282.30 / $1,710.00 / $10,122.46	Facility		$282.30	$1,710.00	$10,122.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.09 / $485.53 / $1,202.58	Professional		$139.09	$485.53	$1,202.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $261.70 / $261.70 / $261.70	Professional		$261.70	$261.70	$261.70
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $950.10 / $3,466.76 / $6,133.17	Facility		$950.10	$3,466.76	$6,133.17
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $273.79 / $1,162.85 / $5,114.96	Professional		$273.79	$1,162.85	$5,114.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,251.15 / $1,251.15 / $1,251.15	Facility		$1,251.15	$1,251.15	$1,251.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.02 / $532.24 / $1,953.13	Professional		$204.02	$532.24	$1,953.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $238.09 / $777.60 / $1,700.14	Facility		$238.09	$777.60	$1,700.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $238.09 / $587.76 / $1,551.67	Professional		$238.09	$587.76	$1,551.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $176.41 / $1,072.74 / $1,787.23	Professional		$176.41	$1,072.74	$1,787.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $666.55 / $1,307.30 / $1,392.93	Facility		$666.55	$1,307.30	$1,392.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $950.10 / $950.10 / $986.18	Facility		$950.10	$950.10	$986.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $292.48 / $816.63 / $1,885.86	Professional		$292.48	$816.63	$1,885.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,822.15 / $4,535.97 / $8,681.78	Facility		$2,822.15	$4,535.97	$8,681.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $292.00 / $610.69 / $1,585.13	Professional		$292.00	$610.69	$1,585.13
United Facility/Professional Facility Modifier Low / Median / High Price $1,050.00 / $1,689.00 / $7,385.00	Facility		$1,050.00	$1,689.00	$7,385.00
United Facility/Professional Professional Modifier Low / Median / High Price $744.28 / $1,242.59 / $2,048.80	Professional		$744.28	$1,242.59	$2,048.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $169.54 / $169.54 / $772.13	Professional		$169.54	$169.54	$772.13