Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $927.18 / $1,835.76 / $17,930.00	Facility		$927.18	$1,835.76	$17,930.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $495.56 / $727.58 / $1,616.16	Professional		$495.56	$727.58	$1,616.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,157.33 / $1,157.33 / $1,157.33	Professional		$1,157.33	$1,157.33	$1,157.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,040.51 / $5,167.93 / $11,429.12	Facility		$1,040.51	$5,167.93	$11,429.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $793.44 / $1,478.04 / $5,242.80	Professional		$793.44	$1,478.04	$5,242.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $644.92 / $1,110.00 / $2,323.83	Facility		$644.92	$1,110.00	$2,323.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $691.45 / $1,077.08 / $1,930.72	Professional		$691.45	$1,077.08	$1,930.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $736.56 / $1,192.95 / $1,817.04	Facility		$736.56	$1,192.95	$1,817.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $791.00 / $1,230.25 / $1,938.66	Professional		$791.00	$1,230.25	$1,938.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $308.60 / $1,424.16	Professional		$71.55	$308.60	$1,424.16
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $930.24 / $1,312.53 / $1,498.44	Facility		$930.24	$1,312.53	$1,498.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.83 / $970.67 / $1,040.51	Facility		$759.83	$970.67	$1,040.51
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $801.82 / $1,327.27 / $1,779.27	Professional		$801.82	$1,327.27	$1,779.27
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,351.17 / $5,167.93 / $9,885.68	Facility		$3,351.17	$5,167.93	$9,885.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $763.69 / $1,109.72 / $1,693.29	Professional		$763.69	$1,109.72	$1,693.29
United Facility/Professional Facility Modifier Low / Median / High Price $629.00 / $1,120.00 / $6,857.00	Facility		$629.00	$1,120.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $835.49 / $1,050.42 / $2,032.39	Professional		$835.49	$1,050.42	$2,032.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $625.59 / $625.59 / $786.99	Professional		$625.59	$625.59	$786.99