Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $703.14 / $3,354.00 / $16,398.00	Facility		$703.14	$3,354.00	$16,398.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $336.93 / $550.50 / $1,425.99	Professional		$336.93	$550.50	$1,425.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $365.12 / $365.12 / $388.38	Professional		$365.12	$365.12	$388.38
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,801.84 / $4,589.03 / $11,500.00	Facility		$1,801.84	$4,589.03	$11,500.00
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $101.02 / $177.12 / $177.12	Facility	AS	$101.02	$177.12	$177.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $629.84 / $1,053.44 / $3,979.84	Professional		$629.84	$1,053.44	$3,979.84
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 $443.52 / $823.45 / $1,540.84	Professional		$443.52	$823.45	$1,540.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $451.64 / $848.97 / $1,498.38	Facility		$451.64	$848.97	$1,498.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $451.64 / $819.79 / $1,382.75	Professional		$451.64	$819.79	$1,382.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.46 / $283.22 / $1,088.01	Professional		$39.46	$283.22	$1,088.01
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $645.55 / $1,002.32 / $1,074.68	Facility		$645.55	$1,002.32	$1,074.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.44 / $712.57 / $1,613.81	Facility		$537.44	$712.57	$1,613.81
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $628.33 / $933.08 / $1,321.93	Professional		$628.33	$933.08	$1,321.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,434.81 / $4,554.63 / $8,712.50	Facility		$3,434.81	$4,554.63	$8,712.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $600.67 / $870.62 / $1,292.61	Professional		$600.67	$870.62	$1,292.61
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 $599.00 / $865.26 / $1,506.70	Professional		$599.00	$865.26	$1,506.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $427.60 / $445.85 / $603.21	Professional		$427.60	$445.85	$603.21