Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $952.33 / $7,394.00 / $18,711.00	Facility		$952.33	$7,394.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $488.01 / $835.65 / $2,660.88	Professional		$488.01	$835.65	$2,660.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $487.95 / $563.35 / $872.80	Professional		$487.95	$563.35	$872.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,437.23 / $9,167.59 / $17,907.41	Facility		$2,437.23	$9,167.59	$17,907.41
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $135.87 / $237.82 / $237.82	Facility	AS	$135.87	$237.82	$237.82
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $867.87 / $1,629.65 / $6,593.20	Professional		$867.87	$1,629.65	$6,593.20
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 $660.27 / $1,266.32 / $2,494.42	Professional		$660.27	$1,266.32	$2,494.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $632.22 / $1,228.48 / $2,824.57	Facility		$632.22	$1,228.48	$2,824.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $632.22 / $1,226.34 / $2,454.60	Professional		$632.22	$1,226.34	$2,454.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.08 / $567.18 / $1,769.02	Professional		$112.08	$567.18	$1,769.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $993.61 / $1,619.06 / $1,776.84	Facility		$993.61	$1,619.06	$1,776.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $986.25 / $1,195.01 / $2,961.46	Facility		$986.25	$1,195.01	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $853.67 / $1,322.20 / $2,197.11	Professional		$853.67	$1,322.20	$2,197.11
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 $818.12 / $1,265.75 / $2,167.78	Professional		$818.12	$1,265.75	$2,167.78
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 $945.76 / $1,421.39 / $2,545.07	Professional		$945.76	$1,421.39	$2,545.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $563.35 / $726.34 / $981.65	Professional		$563.35	$726.34	$981.65