Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $216.20 / $2,327.08 / $4,113.89	Facility		$216.20	$2,327.08	$4,113.89
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $36.09 / $57.37 / $131.47	Facility	53	$36.09	$57.37	$131.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.12 / $238.18 / $684.81	Professional		$94.12	$238.18	$684.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.82 / $224.92 / $360.98	Professional		$94.82	$224.92	$360.98
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $353.79 / $1,824.43 / $3,748.81	Facility		$353.79	$1,824.43	$3,748.81
Asuris Northwest Health Facility/Professional Facility Modifier 53 Low / Median / High Price $51.32 / $89.92 / $89.92	Facility	53	$51.32	$89.92	$89.92
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $167.30 / $470.49 / $1,921.76	Professional		$167.30	$470.49	$1,921.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $880.53	Facility		$714.97	$870.49	$880.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.39 / $291.06 / $732.74	Professional		$127.39	$291.06	$732.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $129.22 / $297.08 / $678.03	Facility		$129.22	$297.08	$678.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.22 / $284.13 / $664.93	Professional		$129.22	$284.13	$664.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.82 / $403.85 / $717.66	Professional		$71.82	$403.85	$717.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $198.32 / $470.18 / $525.95	Facility		$198.32	$470.18	$525.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $238.22 / $353.79 / $715.32	Facility		$238.22	$353.79	$715.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.17 / $329.12 / $645.13	Professional		$165.17	$329.12	$645.13
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,430.01 / $1,958.65 / $3,748.81	Facility		$1,430.01	$1,958.65	$3,748.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $157.24 / $319.75 / $635.76	Professional		$157.24	$319.75	$635.76
United Facility/Professional Facility Modifier Low / Median / High Price $472.00 / $938.00 / $4,611.00	Facility		$472.00	$938.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $309.97 / $408.23 / $732.27	Professional		$309.97	$408.23	$732.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $104.88 / $210.64 / $288.77	Professional		$104.88	$210.64	$288.77