Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.15 / $2,357.19 / $6,629.40	Facility		$103.15	$2,357.19	$6,629.40
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $38.29 / $141.91 / $240.04	Facility	52	$38.29	$141.91	$240.04
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $15.31 / $32.56 / $91.13	Facility	53	$15.31	$32.56	$91.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.93 / $137.26 / $376.16	Professional		$55.93	$137.26	$376.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.46 / $102.92 / $245.47	Professional		$52.46	$102.92	$245.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $255.46 / $2,590.05 / $11,500.00	Facility		$255.46	$2,590.05	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $116.12 / $207.08 / $207.08	Facility	52	$116.12	$207.08	$207.08
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $29.03 / $51.77 / $51.77	Facility	53	$29.03	$51.77	$51.77
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $90.07 / $338.75 / $1,376.00	Professional		$90.07	$338.75	$1,376.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $211.54 / $466.83 / $636.00	Facility		$211.54	$466.83	$636.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.02 / $181.23 / $525.72	Professional		$75.02	$181.23	$525.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $82.82 / $195.40 / $498.00	Facility		$82.82	$195.40	$498.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $78.72 / $170.62 / $400.51	Professional		$78.72	$170.62	$400.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.19 / $328.45 / $557.14	Professional		$53.19	$328.45	$557.14
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $142.79 / $317.58 / $374.53	Facility		$142.79	$317.58	$374.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $168.08 / $255.46 / $256.85	Facility		$168.08	$255.46	$256.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.91 / $219.58 / $484.51	Professional		$91.91	$219.58	$484.51
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,679.53 / $2,590.05 / $4,954.47	Facility		$1,679.53	$2,590.05	$4,954.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $93.95 / $190.92 / $424.56	Professional		$93.95	$190.92	$424.56
United Facility/Professional Facility Modifier Low / Median / High Price $552.00 / $826.70 / $2,344.00	Facility		$552.00	$826.70	$2,344.00
United Facility/Professional Professional Modifier Low / Median / High Price $173.73 / $278.89 / $532.01	Professional		$173.73	$278.89	$532.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.13 / $153.77 / $213.45	Professional		$61.13	$153.77	$213.45