Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $301.95 / $2,293.23 / $8,429.37	Facility		$301.95	$2,293.23	$8,429.37
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $112.83 / $241.58 / $498.49	Facility	52	$112.83	$241.58	$498.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.65 / $337.91 / $936.86	Professional		$163.65	$337.91	$936.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.69 / $263.41 / $320.45	Professional		$131.69	$263.41	$320.45
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $584.91 / $2,511.87 / $16,394.00	Facility		$584.91	$2,511.87	$16,394.00
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $336.28 / $595.82 / $595.82	Facility	52	$336.28	$595.82	$595.82
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $269.35 / $760.75 / $3,058.16	Professional		$269.35	$760.75	$3,058.16
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 $216.62 / $452.50 / $1,159.08	Professional		$216.62	$452.50	$1,159.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $232.32 / $437.93 / $1,081.57	Facility		$232.32	$437.93	$1,081.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $214.52 / $427.92 / $1,010.19	Professional		$214.52	$427.92	$1,010.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $106.96 / $655.08 / $1,114.02	Professional		$106.96	$655.08	$1,114.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $332.09 / $741.69 / $829.46	Facility		$332.09	$741.69	$829.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $430.83 / $575.76 / $666.60	Facility		$430.83	$575.76	$666.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $268.16 / $545.94 / $1,075.44	Professional		$268.16	$545.94	$1,075.44
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 $273.06 / $532.91 / $940.26	Professional		$273.06	$532.91	$940.26
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 $309.95 / $672.80 / $1,180.85	Professional		$309.95	$672.80	$1,180.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $173.22 / $335.42 / $458.54	Professional		$173.22	$335.42	$458.54