Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $715.71 / $2,704.00 / $17,930.00	Facility		$715.71	$2,704.00	$17,930.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $420.77 / $715.71 / $1,281.77	Professional		$420.77	$715.71	$1,281.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $971.95 / $971.95 / $971.95	Professional		$971.95	$971.95	$971.95
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6,520.82 / $10,802.03 / $20,663.07	Facility		$6,520.82	$10,802.03	$20,663.07
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $10,735.34 / $16,203.05 / $31,346.52	Facility	50	$10,735.34	$16,203.05	$31,346.52
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $763.65 / $1,374.81 / $4,850.39	Professional		$763.65	$1,374.81	$4,850.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,186.71 / $2,186.71 / $3,643.05	Facility		$2,186.71	$2,186.71	$3,643.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $612.69 / $1,125.65 / $1,690.18	Professional		$612.69	$1,125.65	$1,690.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $636.83 / $1,060.65 / $8,528.74	Facility		$636.83	$1,060.65	$8,528.74
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $8,528.74 / $9,505.52 / $22,870.24	Facility	50	$8,528.74	$9,505.52	$22,870.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $649.09 / $1,050.33 / $2,454.52	Professional		$649.09	$1,050.33	$2,454.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $74.38 / $263.32 / $1,162.93	Professional		$74.38	$263.32	$1,162.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $688.96 / $953.41 / $1,119.57	Facility		$688.96	$953.41	$1,119.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $742.92 / $763.65 / $1,239.50	Facility		$742.92	$763.65	$1,239.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $786.04 / $1,273.80 / $1,566.23	Professional		$786.04	$1,273.80	$1,566.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,156.89 / $10,795.86 / $20,663.07	Facility		$7,156.89	$10,795.86	$20,663.07
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $10,735.34 / $16,193.79 / $30,994.61	Facility	50	$10,735.34	$16,193.79	$30,994.61
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $757.68 / $1,098.51 / $1,479.67	Professional		$757.68	$1,098.51	$1,479.67
United Facility/Professional Facility Modifier Low / Median / High Price $7,198.00 / $13,695.73 / $21,906.64	Facility		$7,198.00	$13,695.73	$21,906.64
United Facility/Professional Professional Modifier Low / Median / High Price $620.49 / $1,087.46 / $1,604.68	Professional		$620.49	$1,087.46	$1,604.68