Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $286.51 / $5,377.00 / $14,790.16	Facility		$286.51	$5,377.00	$14,790.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.02 / $184.56 / $420.92	Professional		$147.02	$184.56	$420.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $180.55 / $282.35 / $306.55	Professional		$180.55	$282.35	$306.55
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,076.26 / $5,068.58 / $16,394.00	Facility		$1,076.26	$5,068.58	$16,394.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $234.02 / $361.73 / $2,157.98	Professional		$234.02	$361.73	$2,157.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $2,046.84	Facility		$625.25	$761.81	$2,046.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $187.64 / $295.85 / $472.71	Professional		$187.64	$295.85	$472.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $190.24 / $365.24 / $2,097.69	Facility		$190.24	$365.24	$2,097.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.72 / $348.66 / $1,379.07	Professional		$158.72	$348.66	$1,379.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.64 / $270.20 / $457.37	Professional		$44.64	$270.20	$457.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $254.80 / $305.51 / $328.97	Facility		$254.80	$305.51	$328.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $210.19 / $608.39 / $1,167.02	Facility		$210.19	$608.39	$1,167.02
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $224.07 / $353.06 / $426.14	Professional		$224.07	$353.06	$426.14
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,496.71 / $5,392.38 / $10,315.01	Facility		$3,496.71	$5,392.38	$10,315.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $248.24 / $307.67 / $406.29	Professional		$248.24	$307.67	$406.29
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 $178.23 / $275.51 / $448.00	Professional		$178.23	$275.51	$448.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $129.75 / $165.70 / $165.70	Professional		$129.75	$165.70	$165.70