Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $982.44 / $5,429.64 / $17,100.00	Facility		$982.44	$5,429.64	$17,100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $464.53 / $688.70 / $2,168.00	Professional		$464.53	$688.70	$2,168.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $958.94 / $958.94 / $1,087.28	Professional		$958.94	$958.94	$1,087.28
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,729.58 / $4,591.92 / $11,500.00	Facility		$2,729.58	$4,591.92	$11,500.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $754.59 / $1,235.35 / $4,656.30	Professional		$754.59	$1,235.35	$4,656.30
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 $533.50 / $957.90 / $1,627.25	Professional		$533.50	$957.90	$1,627.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $508.90 / $1,055.31 / $1,646.25	Facility		$508.90	$1,055.31	$1,646.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $508.90 / $1,037.03 / $1,471.24	Professional		$508.90	$1,037.03	$1,471.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $316.95 / $1,082.01	Professional		$77.42	$316.95	$1,082.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $739.41 / $1,011.70 / $1,075.34	Facility		$739.41	$1,011.70	$1,075.34
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $440.84 / $707.13 / $1,323.75	Facility		$440.84	$707.13	$1,323.75
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $816.43 / $1,166.83 / $1,455.90	Professional		$816.43	$1,166.83	$1,455.90
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 $721.18 / $1,044.02 / $1,389.93	Professional		$721.18	$1,044.02	$1,389.93
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 $605.20 / $867.33 / $1,519.82	Professional		$605.20	$867.33	$1,519.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $448.61 / $448.61 / $587.72	Professional		$448.61	$448.61	$587.72