Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,188.90 / $5,132.00 / $27,982.24	Facility		$1,188.90	$5,132.00	$27,982.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $604.44 / $847.42 / $1,705.82	Professional		$604.44	$847.42	$1,705.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,282.81 / $1,282.81 / $1,282.81	Professional		$1,282.81	$1,282.81	$1,282.81
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $27,419.55 / $39,805.15	Facility		$2,800.00	$27,419.55	$39,805.15
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $951.53 / $1,523.23 / $5,792.70	Professional		$951.53	$1,523.23	$5,792.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $870.49 / $16,622.56	Facility		$500.00	$870.49	$16,622.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $664.30 / $1,161.91 / $1,963.69	Professional		$664.30	$1,161.91	$1,963.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $742.92 / $1,448.69 / $15,204.72	Facility		$742.92	$1,448.69	$15,204.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $623.02 / $1,380.84 / $11,199.52	Professional		$623.02	$1,380.84	$11,199.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.76 / $750.01 / $1,507.59	Professional		$98.76	$750.01	$1,507.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $988.81 / $1,259.33 / $1,318.56	Facility		$988.81	$1,259.33	$1,318.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $882.90 / $4,836.97 / $9,727.08	Facility		$882.90	$4,836.97	$9,727.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $935.52 / $1,486.04 / $1,793.64	Professional		$935.52	$1,486.04	$1,793.64
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $20,285.72 / $29,154.55 / $55,801.25	Facility		$20,285.72	$29,154.55	$55,801.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,042.71 / $1,293.77 / $1,699.26	Professional		$1,042.71	$1,293.77	$1,699.26
United Facility/Professional Facility Modifier Low / Median / High Price $1,900.00 / $4,686.00 / $19,271.00	Facility		$1,900.00	$4,686.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $690.53 / $1,136.41 / $1,885.63	Professional		$690.53	$1,136.41	$1,885.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $547.16 / $693.41 / $693.41	Professional		$547.16	$693.41	$693.41