Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,353.96 / $10,122.46 / $16,398.00	Facility		$1,353.96	$10,122.46	$16,398.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $679.95 / $987.69 / $3,205.00	Professional		$679.95	$987.69	$3,205.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,229.35 / $1,229.35 / $1,229.35	Professional		$1,229.35	$1,229.35	$1,229.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $997.96 / $7,547.82 / $15,403.47	Facility		$997.96	$7,547.82	$15,403.47
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $388.48 / $646.16 / $646.16	Facility	AS	$388.48	$646.16	$646.16
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,048.52 / $1,705.33 / $6,528.45	Professional		$1,048.52	$1,705.33	$6,528.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $2,846.84	Facility		$714.97	$870.49	$2,846.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $762.38 / $1,320.14 / $2,233.28	Professional		$762.38	$1,320.14	$2,233.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $797.44 / $1,563.02 / $2,496.58	Facility		$797.44	$1,563.02	$2,496.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $762.45 / $1,550.93 / $2,253.29	Professional		$762.45	$1,550.93	$2,253.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $443.67 / $1,472.89	Professional		$78.68	$443.67	$1,472.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,077.02 / $1,432.46 / $1,493.43	Facility		$1,077.02	$1,432.46	$1,493.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $738.78 / $997.96 / $2,218.36	Facility		$738.78	$997.96	$2,218.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,138.07 / $1,630.22 / $2,021.93	Professional		$1,138.07	$1,630.22	$2,021.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,221.67 / $8,047.87 / $15,403.47	Facility		$5,221.67	$8,047.87	$15,403.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,017.79 / $1,449.92 / $1,930.31	Professional		$1,017.79	$1,449.92	$1,930.31
United Facility/Professional Facility Modifier Low / Median / High Price $1,547.00 / $2,408.00 / $10,522.00	Facility		$1,547.00	$2,408.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $919.35 / $1,218.25 / $2,138.58	Professional		$919.35	$1,218.25	$2,138.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $619.50 / $619.50 / $791.07	Professional		$619.50	$619.50	$791.07