Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $321.36 / $2,702.20 / $9,206.32	Facility		$321.36	$2,702.20	$9,206.32
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $120.01 / $257.01 / $465.92	Facility	52	$120.01	$257.01	$465.92
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $48.00 / $102.80 / $186.37	Facility	53	$48.00	$102.80	$186.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.50 / $333.08 / $870.62	Professional		$179.50	$333.08	$870.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $156.83 / $313.67 / $345.62	Professional		$156.83	$313.67	$345.62
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $638.08 / $2,511.87 / $16,394.00	Facility		$638.08	$2,511.87	$16,394.00
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $356.72 / $633.38 / $633.38	Facility	52	$356.72	$633.38	$633.38
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $89.18 / $158.34 / $158.34	Facility	53	$89.18	$158.34	$158.34
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $288.85 / $706.06 / $2,839.20	Professional		$288.85	$706.06	$2,839.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $1,192.33	Facility		$625.25	$761.81	$1,192.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.93 / $469.92 / $1,080.69	Professional		$232.93	$469.92	$1,080.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $247.20 / $462.40 / $1,045.64	Facility		$247.20	$462.40	$1,045.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $227.94 / $456.61 / $934.47	Professional		$227.94	$456.61	$934.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.96 / $599.21 / $1,018.67	Professional		$98.96	$599.21	$1,018.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $351.74 / $696.46 / $774.52	Facility		$351.74	$696.46	$774.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $430.83 / $532.28 / $666.60	Facility		$430.83	$532.28	$666.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $285.83 / $525.09 / $997.58	Professional		$285.83	$525.09	$997.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,814.55 / $2,568.87 / $4,913.96	Facility		$1,814.55	$2,568.87	$4,913.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $290.27 / $535.83 / $875.72	Professional		$290.27	$535.83	$875.72
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $1,120.00 / $6,857.00	Facility		$650.00	$1,120.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $314.07 / $623.63 / $1,095.34	Professional		$314.07	$623.63	$1,095.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $183.84 / $312.79 / $424.56	Professional		$183.84	$312.79	$424.56