Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.55 / $617.59 / $13,750.00	Facility		$119.55	$617.59	$13,750.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.22 / $171.53 / $526.30	Professional		$66.22	$171.53	$526.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $579.72	Professional		$106.33	$106.33	$579.72
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $435.52 / $1,504.79 / $2,557.48	Facility		$435.52	$1,504.79	$2,557.48
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,779.21 / $2,903.78 / $5,617.67	Facility	50	$1,779.21	$2,903.78	$5,617.67
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $112.80 / $461.08 / $2,348.80	Professional		$112.80	$461.08	$2,348.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.93 / $197.56 / $855.46	Professional		$84.93	$197.56	$855.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $198.19 / $814.49	Facility		$95.50	$198.19	$814.49
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,701.49 / $2,768.63 / $5,027.38	Facility	50	$1,701.49	$2,768.63	$5,027.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $90.24 / $169.60 / $463.59	Professional		$90.24	$169.60	$463.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.57 / $489.21 / $824.25	Professional		$81.57	$489.21	$824.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $130.65 / $510.24 / $638.51	Facility		$130.65	$510.24	$638.51
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $435.52 / $435.52 / $452.09	Facility		$435.52	$435.52	$452.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.40 / $287.11 / $812.66	Professional		$116.40	$287.11	$812.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,412.56 / $1,934.75 / $3,703.07	Facility		$1,412.56	$1,934.75	$3,703.07
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $2,118.84 / $2,902.13 / $5,554.61	Facility	50	$2,118.84	$2,902.13	$5,554.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $105.38 / $243.03 / $723.80	Professional		$105.38	$243.03	$723.80
United Facility/Professional Facility Modifier Low / Median / High Price $1,784.67 / $2,387.23 / $4,511.14	Facility		$1,784.67	$2,387.23	$4,511.14
United Facility/Professional Professional Modifier Low / Median / High Price $230.50 / $441.60 / $941.36	Professional		$230.50	$441.60	$941.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $70.30 / $70.30 / $358.37	Professional		$70.30	$70.30	$358.37