Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $853.00 / $4,500.00 / $17,575.02	Facility		$853.00	$4,500.00	$17,575.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $509.78 / $754.43 / $2,435.67	Professional		$509.78	$754.43	$2,435.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $442.81 / $461.43 / $584.30	Professional		$442.81	$461.43	$584.30
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,188.56 / $9,167.59 / $17,907.41	Facility		$2,188.56	$9,167.59	$17,907.41
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $121.34 / $213.75 / $213.75	Facility	AS	$121.34	$213.75	$213.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $798.75 / $1,330.90 / $5,127.76	Professional		$798.75	$1,330.90	$5,127.76
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 $593.58 / $1,062.58 / $1,972.51	Professional		$593.58	$1,062.58	$1,972.51
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $657.52 / $1,172.82 / $2,806.97	Facility		$657.52	$1,172.82	$2,806.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $656.22 / $1,146.41 / $2,183.42	Professional		$656.22	$1,146.41	$2,183.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.79 / $399.13 / $1,378.76	Professional		$78.79	$399.13	$1,378.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $883.47 / $1,348.73 / $1,445.86	Facility		$883.47	$1,348.73	$1,445.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $921.40 / $945.08 / $2,961.46	Facility		$921.40	$945.08	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $765.69 / $1,146.06 / $1,709.51	Professional		$765.69	$1,146.06	$1,709.51
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,948.17 / $9,167.59 / $17,546.59	Facility		$5,948.17	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $736.47 / $1,104.46 / $1,671.44	Professional		$736.47	$1,104.46	$1,671.44
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 $850.63 / $1,128.05 / $1,980.25	Professional		$850.63	$1,128.05	$1,980.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $508.09 / $568.70 / $763.81	Professional		$508.09	$568.70	$763.81