Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $932.18 / $1,652.52 / $2,605.23	Professional		$932.18	$1,652.52	$2,605.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,299.23 / $2,299.23 / $2,299.23	Professional		$2,299.23	$2,299.23	$2,299.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $289.47 / $14,832.59 / $14,832.59	Facility		$289.47	$14,832.59	$14,832.59
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,835.37 / $2,433.71 / $3,471.09	Professional		$1,835.37	$2,433.71	$3,471.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,440.00 / $1,440.00 / $1,468.80	Facility		$1,440.00	$1,440.00	$1,468.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,224.00 / $1,440.00 / $2,199.96	Professional		$1,224.00	$1,440.00	$2,199.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,305.80 / $3,305.80 / $3,305.80	Facility		$3,305.80	$3,305.80	$3,305.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,305.80 / $3,305.80 / $3,305.80	Professional		$3,305.80	$3,305.80	$3,305.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $290.54 / $355.11 / $3,551.13	Professional		$290.54	$355.11	$3,551.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,795.63 / $5,098.06 / $5,614.60	Facility		$2,795.63	$5,098.06	$5,614.60
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,609.00 / $5,536.00 / $5,614.60	Professional		$4,609.00	$5,536.00	$5,614.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $289.47 / $289.47 / $289.47	Facility		$289.47	$289.47	$289.47
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,744.06 / $3,131.45 / $5,821.03	Professional		$2,744.06	$3,131.45	$5,821.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $223.23 / $223.23 / $271.80	Professional		$223.23	$223.23	$271.80
United Facility/Professional Professional Modifier Low / Median / High Price $1,296.16 / $1,391.26 / $2,318.76	Professional		$1,296.16	$1,391.26	$2,318.76