Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $470.15 / $4,500.00 / $13,902.24	Facility		$470.15	$4,500.00	$13,902.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $271.89 / $637.89 / $1,412.78	Professional		$271.89	$637.89	$1,412.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $498.24 / $498.24 / $498.24	Professional		$498.24	$498.24	$498.24
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,486.75 / $9,032.98 / $17,279.07	Facility		$1,486.75	$9,032.98	$17,279.07
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $65.25 / $116.26 / $116.26	Facility	AS	$65.25	$116.26	$116.26
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $457.96 / $1,493.24 / $5,987.20	Professional		$457.96	$1,493.24	$5,987.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,763.00 / $3,763.00 / $3,763.00	Facility		$3,763.00	$3,763.00	$3,763.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $410.40 / $848.69 / $2,473.67	Professional		$410.40	$848.69	$2,473.67
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $411.47 / $1,102.31 / $2,923.63	Facility		$411.47	$1,102.31	$2,923.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $407.86 / $866.20 / $2,202.19	Professional		$407.86	$866.20	$2,202.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.32 / $959.94 / $1,813.21	Professional		$98.32	$959.94	$1,813.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $569.25 / $1,453.90 / $1,711.18	Facility		$569.25	$1,453.90	$1,711.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,110.51 / $1,110.51 / $1,169.65	Facility		$1,110.51	$1,110.51	$1,169.65
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $438.50 / $848.38 / $2,035.61	Professional		$438.50	$848.38	$2,035.61
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,857.48 / $9,027.82 / $17,279.07	Facility		$5,857.48	$9,027.82	$17,279.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $427.71 / $783.22 / $1,880.82	Professional		$427.71	$783.22	$1,880.82
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $6,594.00 / $12,835.00	Facility		$2,155.00	$6,594.00	$12,835.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,019.49 / $1,449.91 / $2,419.54	Professional		$1,019.49	$1,449.91	$2,419.54