Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,005.45 / $2,249.46 / $14,960.00	Facility		$1,005.45	$2,249.46	$14,960.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $614.62 / $825.32 / $1,928.44	Professional		$614.62	$825.32	$1,928.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,346.52 / $1,346.52 / $1,412.22	Professional		$1,346.52	$1,346.52	$1,412.22
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,058.41 / $5,167.93 / $11,429.12	Facility		$1,058.41	$5,167.93	$11,429.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $909.72 / $1,493.37 / $7,000.00	Professional		$909.72	$1,493.37	$7,000.00
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 $802.99 / $1,196.39 / $2,225.75	Professional		$802.99	$1,196.39	$2,225.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $884.40 / $1,347.57 / $2,050.31	Facility		$884.40	$1,347.57	$2,050.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $938.50 / $1,454.92 / $2,125.62	Professional		$938.50	$1,454.92	$2,125.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.32 / $380.94 / $1,518.77	Professional		$72.32	$380.94	$1,518.77
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,082.41 / $1,441.00 / $1,563.32	Facility		$1,082.41	$1,441.00	$1,563.32
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.83 / $1,040.51 / $1,058.41	Facility		$759.83	$1,040.51	$1,058.41
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $937.65 / $1,520.79 / $1,952.86	Professional		$937.65	$1,520.79	$1,952.86
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 $886.72 / $1,281.59 / $1,851.21	Professional		$886.72	$1,281.59	$1,851.21
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 $857.49 / $1,056.00 / $2,182.15	Professional		$857.49	$1,056.00	$2,182.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $727.85 / $727.85 / $850.97	Professional		$727.85	$727.85	$850.97