Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $626.72 / $4,500.00 / $13,809.00	Facility		$626.72	$4,500.00	$13,809.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $333.29 / $623.32 / $1,702.20	Professional		$333.29	$623.32	$1,702.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $315.25 / $315.25 / $315.25	Professional		$315.25	$315.25	$315.25
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,587.64 / $4,591.92 / $11,500.00	Facility		$1,587.64	$4,591.92	$11,500.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $579.80 / $1,059.18 / $4,083.04	Professional		$579.80	$1,059.18	$4,083.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $1,677.65	Facility		$625.25	$761.81	$1,677.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $421.13 / $776.09 / $1,563.96	Professional		$421.13	$776.09	$1,563.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $421.91 / $788.61 / $1,436.99	Facility		$421.91	$788.61	$1,436.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $421.91 / $772.07 / $1,338.26	Professional		$421.91	$772.07	$1,338.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.50 / $305.32 / $1,111.26	Professional		$39.50	$305.32	$1,111.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $611.44 / $960.78 / $1,115.55	Facility		$611.44	$960.78	$1,115.55
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $440.84 / $750.62 / $1,323.75	Facility		$440.84	$750.62	$1,323.75
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $559.09 / $855.99 / $1,388.61	Professional		$559.09	$855.99	$1,388.61
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,264.85 / $4,591.92 / $8,788.86	Facility		$3,264.85	$4,591.92	$8,788.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $537.34 / $808.61 / $1,329.08	Professional		$537.34	$808.61	$1,329.08
United Facility/Professional Facility Modifier Low / Median / High Price $702.00 / $1,436.00 / $6,857.00	Facility		$702.00	$1,436.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $644.85 / $916.30 / $1,608.52	Professional		$644.85	$916.30	$1,608.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $376.19 / $456.89 / $621.65	Professional		$376.19	$456.89	$621.65