Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $964.32 / $4,487.03 / $18,800.00	Facility		$964.32	$4,487.03	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $469.82 / $734.51 / $1,794.34	Professional		$469.82	$734.51	$1,794.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $872.27 / $872.27 / $872.27	Professional		$872.27	$872.27	$872.27
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,737.10 / $4,554.63 / $11,500.00	Facility		$1,737.10	$4,554.63	$11,500.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $779.45 / $1,280.33 / $4,814.03	Professional		$779.45	$1,280.33	$4,814.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $1,985.59	Facility		$714.97	$870.49	$1,985.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $536.10 / $1,014.82 / $1,715.68	Professional		$536.10	$1,014.82	$1,715.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $519.82 / $1,053.86 / $1,787.81	Facility		$519.82	$1,053.86	$1,787.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $485.62 / $1,025.86 / $1,635.25	Professional		$485.62	$1,025.86	$1,635.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.50 / $310.06 / $1,111.65	Professional		$39.50	$310.06	$1,111.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $680.24 / $984.90 / $1,110.19	Facility		$680.24	$984.90	$1,110.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.44 / $750.17 / $1,613.81	Facility		$537.44	$750.17	$1,613.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $854.28 / $1,225.44 / $1,503.06	Professional		$854.28	$1,225.44	$1,503.06
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,323.45 / $4,552.03 / $8,712.50	Facility		$3,323.45	$4,552.03	$8,712.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $765.07 / $1,077.83 / $1,434.96	Professional		$765.07	$1,077.83	$1,434.96
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 $617.49 / $823.20 / $1,605.62	Professional		$617.49	$823.20	$1,605.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $456.06 / $456.06 / $618.61	Professional		$456.06	$456.06	$618.61