Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $653.44 / $1,610.91 / $13,809.00	Facility		$653.44	$1,610.91	$13,809.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $348.00 / $652.05 / $1,122.76	Professional		$348.00	$652.05	$1,122.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $555.36 / $878.91 / $1,787.73	Professional		$555.36	$878.91	$1,787.73
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $350.25 / $1,779.82 / $3,404.60	Facility		$350.25	$1,779.82	$3,404.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $505.17 / $1,249.74 / $5,075.35	Professional		$505.17	$1,249.74	$5,075.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $421.10 / $731.00 / $777.59	Facility		$421.10	$731.00	$777.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $465.08 / $861.55 / $1,816.82	Professional		$465.08	$861.55	$1,816.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $491.58 / $833.56 / $1,560.66	Facility		$491.58	$833.56	$1,560.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $503.71 / $863.36 / $1,639.57	Professional		$503.71	$863.36	$1,639.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $186.57 / $1,044.87 / $1,845.74	Professional		$186.57	$1,044.87	$1,845.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $751.72 / $1,227.44 / $1,370.15	Facility		$751.72	$1,227.44	$1,370.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $236.51 / $900.11 / $934.57	Facility		$236.51	$900.11	$934.57
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $497.81 / $934.57 / $1,693.67	Professional		$497.81	$934.57	$1,693.67
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,154.13 / $1,778.80 / $3,404.60	Facility		$1,154.13	$1,778.80	$3,404.60
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $477.71 / $907.26 / $1,582.80	Professional		$477.71	$907.26	$1,582.80
United Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $588.00 / $5,793.00	Facility		$140.00	$588.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $813.33 / $1,055.13 / $1,961.90	Professional		$813.33	$1,055.13	$1,961.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $375.21 / $375.21 / $763.52	Professional		$375.21	$375.21	$763.52