Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,054.04 / $9,350.64 / $32,098.99	Facility		$1,054.04	$9,350.64	$32,098.99
Aetna Facility/Professional Facility Modifier 80 Low / Median / High Price $24,283.63 / $24,283.63 / $24,283.63	Facility	80	$24,283.63	$24,283.63	$24,283.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $558.59 / $897.65 / $2,942.15	Professional		$558.59	$897.65	$2,942.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $542.35 / $847.96 / $8,213.09	Professional		$542.35	$847.96	$8,213.09
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,722.60 / $20,273.81 / $28,095.15	Facility		$2,722.60	$20,273.81	$28,095.15
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $149.66 / $264.92 / $264.92	Facility	AS	$149.66	$264.92	$264.92
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $980.50 / $1,548.88 / $5,798.24	Professional		$980.50	$1,548.88	$5,798.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $11,732.50	Facility		$883.20	$1,075.31	$11,732.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $730.59 / $1,251.04 / $2,217.42	Professional		$730.59	$1,251.04	$2,217.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $724.78 / $1,344.35 / $7,904.82	Facility		$724.78	$1,344.35	$7,904.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $724.78 / $1,308.48 / $5,090.14	Professional		$724.78	$1,308.48	$5,090.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.89 / $464.71 / $1,570.58	Professional		$78.89	$464.71	$1,570.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $982.38 / $1,523.30 / $1,581.68	Facility		$982.38	$1,523.30	$1,581.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,053.68 / $1,071.21 / $9,446.76	Facility		$1,053.68	$1,071.21	$9,446.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $958.62 / $1,393.97 / $1,946.22	Professional		$958.62	$1,393.97	$1,946.22
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,146.66 / $20,262.22 / $38,781.51	Facility		$13,146.66	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $913.42 / $1,323.81 / $1,923.25	Professional		$913.42	$1,323.81	$1,923.25
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $5,547.00 / $19,271.00	Facility		$3,028.00	$5,547.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $965.58 / $1,264.45 / $2,254.44	Professional		$965.58	$1,264.45	$2,254.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $628.12 / $644.05 / $858.18	Professional		$628.12	$644.05	$858.18