Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $786.03 / $1,802.67 / $14,464.32	Facility		$786.03	$1,802.67	$14,464.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $532.95 / $786.03 / $1,613.08	Professional		$532.95	$786.03	$1,613.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,236.02 / $1,236.02 / $1,236.02	Professional		$1,236.02	$1,236.02	$1,236.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,060.70 / $5,167.93 / $11,429.12	Facility		$1,060.70	$5,167.93	$11,429.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $860.95 / $1,606.13 / $5,728.24	Professional		$860.95	$1,606.13	$5,728.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $564.00 / $906.00 / $2,323.83	Facility		$564.00	$906.00	$2,323.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $764.22 / $1,186.14 / $2,071.75	Professional		$764.22	$1,186.14	$2,071.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $800.44 / $1,279.61 / $1,986.82	Facility		$800.44	$1,279.61	$1,986.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $855.00 / $1,332.05 / $2,125.62	Professional		$855.00	$1,332.05	$2,125.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.04 / $453.68 / $1,555.44	Professional		$75.04	$453.68	$1,555.44
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,007.19 / $1,428.04 / $1,555.07	Facility		$1,007.19	$1,428.04	$1,555.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.83 / $1,040.51 / $1,060.70	Facility		$759.83	$1,040.51	$1,060.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $861.98 / $1,428.89 / $1,944.30	Professional		$861.98	$1,428.89	$1,944.30
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 $823.75 / $1,192.98 / $1,869.39	Professional		$823.75	$1,192.98	$1,869.39
United Facility/Professional Facility Modifier Low / Median / High Price $629.00 / $1,612.00 / $6,857.00	Facility		$629.00	$1,612.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $923.16 / $1,176.15 / $2,223.54	Professional		$923.16	$1,176.15	$2,223.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $668.12 / $668.12 / $856.35	Professional		$668.12	$668.12	$856.35