Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $793.43 / $5,197.85 / $27,982.24	Facility		$793.43	$5,197.85	$27,982.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $408.93 / $1,353.12 / $3,850.41	Professional		$408.93	$1,353.12	$3,850.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $711.30 / $711.30 / $711.30	Professional		$711.30	$711.30	$711.30
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,055.05 / $29,304.00 / $59,636.26	Facility		$3,055.05	$29,304.00	$59,636.26
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $743.17 / $4,090.55 / $16,456.24	Professional		$743.17	$4,090.55	$16,456.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $15,374.94 / $15,374.94 / $15,374.94	Facility		$15,374.94	$15,374.94	$15,374.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $669.96 / $1,400.62 / $6,829.22	Professional		$669.96	$1,400.62	$6,829.22
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $699.30 / $3,479.01 / $10,258.49	Facility		$699.30	$3,479.01	$10,258.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $686.91 / $2,783.21 / $7,384.15	Professional		$686.91	$2,783.21	$7,384.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $553.47 / $3,394.35 / $5,656.64	Professional		$553.47	$3,394.35	$5,656.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $862.29 / $4,242.47 / $4,872.72	Facility		$862.29	$4,242.47	$4,872.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,055.05 / $3,055.05 / $3,208.60	Facility		$3,055.05	$3,055.05	$3,208.60
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $739.64 / $1,431.02 / $5,600.02	Professional		$739.64	$1,431.02	$5,600.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $22,748.67 / $31,176.05 / $59,636.26	Facility		$22,748.67	$31,176.05	$59,636.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $694.67 / $1,321.11 / $5,174.18	Professional		$694.67	$1,321.11	$5,174.18
United Facility/Professional Facility Modifier Low / Median / High Price $3,340.00 / $13,441.00 / $26,100.00	Facility		$3,340.00	$13,441.00	$26,100.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,915.10 / $4,173.00 / $6,806.24	Professional		$2,915.10	$4,173.00	$6,806.24