Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $307.54 / $925.26 / $13,809.00	Facility		$307.54	$925.26	$13,809.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.85 / $455.80 / $925.26	Professional		$239.85	$455.80	$925.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $196.51 / $196.51 / $196.51	Professional		$196.51	$196.51	$196.51
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $817.73 / $3,269.98 / $16,394.00	Facility		$817.73	$3,269.98	$16,394.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $380.96 / $948.73 / $3,602.00	Professional		$380.96	$948.73	$3,602.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $1,499.24	Facility		$625.25	$761.81	$1,499.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $304.79 / $605.21 / $1,363.40	Professional		$304.79	$605.21	$1,363.40
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $344.00 / $652.11 / $1,274.95	Facility		$344.00	$652.11	$1,274.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $328.00 / $621.03 / $1,189.44	Professional		$328.00	$621.03	$1,189.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $132.83 / $801.94 / $1,360.38	Professional		$132.83	$801.94	$1,360.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $512.95 / $865.26 / $979.54	Facility		$512.95	$865.26	$979.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $552.13 / $678.14 / $874.44	Facility		$552.13	$678.14	$874.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $370.43 / $668.13 / $1,270.98	Professional		$370.43	$668.13	$1,270.98
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 $386.76 / $691.86 / $1,120.95	Professional		$386.76	$691.86	$1,120.95
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 $527.66 / $807.94 / $1,395.54	Professional		$527.66	$807.94	$1,395.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $236.38 / $398.64 / $539.05	Professional		$236.38	$398.64	$539.05