Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $497.01 / $1,733.00 / $14,117.48	Facility		$497.01	$1,733.00	$14,117.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.68 / $584.57 / $1,459.88	Professional		$347.68	$584.57	$1,459.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $429.33 / $429.33 / $872.80	Professional		$429.33	$429.33	$872.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,843.36 / $9,167.59 / $16,394.00	Facility		$1,843.36	$9,167.59	$16,394.00
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $102.06 / $179.69 / $179.69	Facility	AS	$102.06	$179.69	$179.69
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $654.85 / $1,111.07 / $4,256.47	Professional		$654.85	$1,111.07	$4,256.47
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 $474.82 / $863.71 / $1,643.54	Professional		$474.82	$863.71	$1,643.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $461.74 / $874.26 / $2,806.97	Facility		$461.74	$874.26	$2,806.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $461.74 / $860.09 / $1,834.79	Professional		$461.74	$860.09	$1,834.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $312.63 / $1,148.94	Professional		$77.42	$312.63	$1,148.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $706.13 / $1,079.36 / $1,151.73	Facility		$706.13	$1,079.36	$1,151.73
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $763.76 / $785.58 / $2,961.46	Facility		$763.76	$785.58	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $643.66 / $958.97 / $1,415.28	Professional		$643.66	$958.97	$1,415.28
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 $619.46 / $914.37 / $1,404.73	Professional		$619.46	$914.37	$1,404.73
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 $657.20 / $888.53 / $1,626.56	Professional		$657.20	$888.53	$1,626.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $429.33 / $472.08 / $635.72	Professional		$429.33	$472.08	$635.72