Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,647.62 / $5,116.62 / $22,024.00	Facility		$1,647.62	$5,116.62	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,117.29 / $1,560.55 / $3,317.90	Professional		$1,117.29	$1,560.55	$3,317.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,797.98 / $1,797.98 / $14,058.03	Professional		$1,797.98	$1,797.98	$14,058.03
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $11,500.00 / $36,469.56 / $71,345.31	Facility		$11,500.00	$36,469.56	$71,345.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,757.01 / $2,793.26 / $10,783.73	Professional		$1,757.01	$2,793.26	$10,783.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $20,082.09	Facility		$714.97	$870.49	$20,082.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,270.77 / $2,200.73 / $3,732.69	Professional		$1,270.77	$2,200.73	$3,732.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,293.83 / $2,657.56 / $17,611.34	Facility		$1,293.83	$2,657.56	$17,611.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,181.31 / $2,549.10 / $15,164.96	Professional		$1,181.31	$2,549.10	$15,164.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $156.04 / $713.01 / $2,400.51	Professional		$156.04	$713.01	$2,400.51
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,718.93 / $2,359.07 / $2,481.67	Facility		$1,718.93	$2,359.07	$2,481.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,644.84 / $1,692.73 / $17,965.68	Facility		$1,644.84	$1,692.73	$17,965.68
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,886.16 / $2,692.81 / $3,359.90	Professional		$1,886.16	$2,692.81	$3,359.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $24,749.60 / $37,275.87 / $71,345.31	Facility		$24,749.60	$37,275.87	$71,345.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,677.52 / $2,409.38 / $3,230.48	Professional		$1,677.52	$2,409.38	$3,230.48
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 $1,483.43 / $2,013.23 / $3,496.66	Professional		$1,483.43	$2,013.23	$3,496.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,030.83 / $1,030.83 / $1,331.84	Professional		$1,030.83	$1,030.83	$1,331.84