Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $243.23 / $558.40 / $13,750.00	Facility		$243.23	$558.40	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.65 / $210.45 / $450.27	Professional		$128.65	$210.45	$450.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $476.04 / $476.04 / $476.04	Professional		$476.04	$476.04	$476.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $5,308.60 / $12,053.91	Facility		$55.00	$5,308.60	$12,053.91
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $210.55 / $447.85 / $1,708.32	Professional		$210.55	$447.85	$1,708.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $231.79 / $466.83 / $636.00	Facility		$231.79	$466.83	$636.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.50 / $331.63 / $648.63	Professional		$168.50	$331.63	$648.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $172.20 / $312.79 / $610.19	Facility		$172.20	$312.79	$610.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $168.10 / $304.72 / $530.32	Professional		$168.10	$304.72	$530.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.58 / $250.02 / $540.16	Professional		$42.58	$250.02	$540.16
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $255.94 / $411.85 / $464.31	Facility		$255.94	$411.85	$464.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $183.04 / $313.02 / $316.70	Facility		$183.04	$313.02	$316.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $216.50 / $355.68 / $596.75	Professional		$216.50	$355.68	$596.75
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,916.52 / $9,118.81 / $17,453.22	Facility		$5,916.52	$9,118.81	$17,453.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $218.34 / $352.99 / $526.33	Professional		$218.34	$352.99	$526.33
United Facility/Professional Facility Modifier Low / Median / High Price $805.00 / $1,681.00 / $3,740.00	Facility		$805.00	$1,681.00	$3,740.00
United Facility/Professional Professional Modifier Low / Median / High Price $231.50 / $377.39 / $706.08	Professional		$231.50	$377.39	$706.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $143.27 / $188.00 / $257.32	Professional		$143.27	$188.00	$257.32