Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $866.23 / $1,786.37 / $16,398.00	Facility		$866.23	$1,786.37	$16,398.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $433.23 / $674.46 / $1,593.86	Professional		$433.23	$674.46	$1,593.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $488.18 / $488.18 / $617.91	Professional		$488.18	$488.18	$617.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,213.08 / $9,172.83 / $20,286.13	Facility		$2,213.08	$9,172.83	$20,286.13
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $122.02 / $215.87 / $215.87	Facility	AS	$122.02	$215.87	$215.87
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $782.90 / $1,304.11 / $4,899.60	Professional		$782.90	$1,304.11	$4,899.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $3,740.43	Facility		$714.97	$870.49	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $570.00 / $1,025.29 / $1,885.73	Professional		$570.00	$1,025.29	$1,885.73
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $565.72 / $1,060.65 / $2,806.97	Facility		$565.72	$1,060.65	$2,806.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $565.72 / $1,053.11 / $2,099.35	Professional		$565.72	$1,053.11	$2,099.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $387.92 / $1,321.02	Professional		$78.68	$387.92	$1,321.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $774.21 / $1,245.16 / $1,328.61	Facility		$774.21	$1,245.16	$1,328.61
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $884.26 / $906.23 / $2,961.46	Facility		$884.26	$906.23	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $778.92 / $1,156.43 / $1,642.00	Professional		$778.92	$1,156.43	$1,642.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,693.27 / $9,167.59 / $17,546.59	Facility		$6,693.27	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $746.48 / $1,085.98 / $1,604.06	Professional		$746.48	$1,085.98	$1,604.06
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,129.00 / $11,941.00	Facility		$2,155.00	$3,129.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $769.60 / $1,071.60 / $1,879.64	Professional		$769.60	$1,071.60	$1,879.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $513.87 / $545.23 / $730.52	Professional		$513.87	$545.23	$730.52