Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,198.59 / $2,022.85 / $18,711.00	Facility		$1,198.59	$2,022.85	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $571.97 / $769.16 / $1,587.49	Professional		$571.97	$769.16	$1,587.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,306.73 / $1,306.73 / $1,306.73	Professional		$1,306.73	$1,306.73	$1,306.73
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,060.70 / $6,622.22 / $14,645.34	Facility		$1,060.70	$6,622.22	$14,645.34
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $6,634.41 / $9,933.33 / $19,217.09	Facility	50	$6,634.41	$9,933.33	$19,217.09
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,050.08 / $1,671.13 / $5,797.76	Professional		$1,050.08	$1,671.13	$5,797.76
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,627.04 / $2,310.41 / $3,139.50	Professional	50	$1,627.04	$2,310.41	$3,139.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $734.00 / $734.00 / $2,430.19	Facility		$734.00	$734.00	$2,430.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $657.33 / $1,160.64 / $2,205.84	Professional		$657.33	$1,160.64	$2,205.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $807.54 / $1,186.00 / $2,043.70	Facility		$807.54	$1,186.00	$2,043.70
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $5,752.58 / $6,328.28 / $15,568.54	Facility	50	$5,752.58	$6,328.28	$15,568.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $808.15 / $1,215.96 / $1,997.11	Professional		$808.15	$1,215.96	$1,997.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $463.32 / $1,512.91	Professional		$79.43	$463.32	$1,512.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,043.04 / $1,455.91 / $1,555.07	Facility		$1,043.04	$1,455.91	$1,555.07
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $925.25 / $1,033.75 / $1,060.70	Facility		$925.25	$1,033.75	$1,060.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,042.33 / $1,520.66 / $1,990.36	Professional		$1,042.33	$1,520.66	$1,990.36
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,294.21 / $6,618.43 / $12,667.56	Facility		$4,294.21	$6,618.43	$12,667.56
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $6,441.32 / $9,927.65 / $19,001.34	Facility	50	$6,441.32	$9,927.65	$19,001.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $873.64 / $1,453.86 / $1,991.41	Professional		$873.64	$1,453.86	$1,991.41
United Facility/Professional Facility Modifier Low / Median / High Price $1,220.00 / $2,136.00 / $10,522.00	Facility		$1,220.00	$2,136.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $885.00 / $1,207.80 / $2,170.21	Professional		$885.00	$1,207.80	$2,170.21