Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.45 / $1,587.41 / $12,214.00	Facility		$213.45	$1,587.41	$12,214.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $79.90 / $171.48 / $755.45	Facility	52	$79.90	$171.48	$755.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.19 / $310.39 / $945.91	Professional		$122.19	$310.39	$945.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.01 / $146.01 / $161.15	Professional		$146.01	$146.01	$161.15
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $817.73 / $3,269.98 / $12,000.00	Facility		$817.73	$3,269.98	$12,000.00
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $239.05 / $422.66 / $422.66	Facility	52	$239.05	$422.66	$422.66
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $198.07 / $915.16 / $3,618.00	Professional		$198.07	$915.16	$3,618.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $466.83 / $568.48 / $1,499.24	Facility		$466.83	$568.48	$1,499.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.57 / $356.96 / $1,449.49	Professional		$161.57	$356.96	$1,449.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $173.25 / $428.22 / $1,397.91	Facility		$173.25	$428.22	$1,397.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $160.96 / $378.86 / $1,357.64	Professional		$160.96	$378.86	$1,357.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $124.10 / $767.38 / $1,298.46	Professional		$124.10	$767.38	$1,298.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $279.87 / $890.34 / $1,046.54	Facility		$279.87	$890.34	$1,046.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $552.13 / $696.26 / $874.44	Facility		$552.13	$696.26	$874.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $191.58 / $387.24 / $1,287.42	Professional		$191.58	$387.24	$1,287.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,168.55 / $3,344.18 / $6,397.05	Facility		$2,168.55	$3,344.18	$6,397.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $197.15 / $365.05 / $1,139.90	Professional		$197.15	$365.05	$1,139.90
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 $232.67 / $841.68 / $1,465.43	Professional		$232.67	$841.68	$1,465.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $123.43 / $392.84 / $547.25	Professional		$123.43	$392.84	$547.25