Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $894.05 / $2,143.46 / $13,572.27	Facility		$894.05	$2,143.46	$13,572.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $528.65 / $788.16 / $1,962.37	Professional		$528.65	$788.16	$1,962.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $371.49 / $535.15 / $872.80	Professional		$371.49	$535.15	$872.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,308.64 / $9,167.59 / $16,394.00	Facility		$2,308.64	$9,167.59	$16,394.00
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $128.47 / $224.95 / $224.95	Facility	AS	$128.47	$224.95	$224.95
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $816.30 / $1,369.88 / $5,229.43	Professional		$816.30	$1,369.88	$5,229.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $3,740.43	Facility		$625.25	$761.81	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $640.78 / $1,093.78 / $2,001.26	Professional		$640.78	$1,093.78	$2,001.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $689.56 / $1,236.51 / $2,806.97	Facility		$689.56	$1,236.51	$2,806.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $676.73 / $1,202.47 / $2,197.50	Professional		$676.73	$1,202.47	$2,197.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.45 / $453.74 / $1,394.53	Professional		$79.45	$453.74	$1,394.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $911.58 / $1,374.20 / $1,494.05	Facility		$911.58	$1,374.20	$1,494.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $929.10 / $960.61 / $2,961.46	Facility		$929.10	$960.61	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $802.02 / $1,195.81 / $1,724.51	Professional		$802.02	$1,195.81	$1,724.51
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 $774.60 / $1,122.68 / $1,685.40	Professional		$774.60	$1,122.68	$1,685.40
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,297.00 / $11,941.00	Facility		$2,155.00	$3,297.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $835.60 / $1,144.33 / $2,081.42	Professional		$835.60	$1,144.33	$2,081.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $535.15 / $578.36 / $775.48	Professional		$535.15	$578.36	$775.48