Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,312.67 / $2,622.41 / $12,214.00	Facility		$1,312.67	$2,622.41	$12,214.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $737.78 / $975.45 / $2,196.75	Professional		$737.78	$975.45	$2,196.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,621.42 / $2,621.42 / $2,621.42	Professional		$2,621.42	$2,621.42	$2,621.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,375.57 / $5,367.06 / $11,429.12	Facility		$1,375.57	$5,367.06	$11,429.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,158.50 / $2,133.40 / $7,470.40	Professional		$1,158.50	$2,133.40	$7,470.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $564.00 / $906.00 / $2,323.83	Facility		$564.00	$906.00	$2,323.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,026.03 / $1,557.91 / $2,831.68	Professional		$1,026.03	$1,557.91	$2,831.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,111.05 / $1,677.35 / $2,542.33	Facility		$1,111.05	$1,677.35	$2,542.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,176.14 / $1,722.12 / $2,605.67	Professional		$1,176.14	$1,722.12	$2,605.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $110.12 / $473.95 / $1,977.47	Professional		$110.12	$473.95	$1,977.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,181.53 / $1,869.49 / $2,016.70	Facility		$1,181.53	$1,869.49	$2,016.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.83 / $1,329.10 / $1,375.57	Facility		$759.83	$1,329.10	$1,375.57
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,191.45 / $1,950.34 / $2,542.46	Professional		$1,191.45	$1,950.34	$2,542.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,351.17 / $5,167.93 / $9,885.68	Facility		$3,351.17	$5,167.93	$9,885.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,138.83 / $1,632.71 / $2,410.12	Professional		$1,138.83	$1,632.71	$2,410.12
United Facility/Professional Facility Modifier Low / Median / High Price $629.00 / $1,120.00 / $6,857.00	Facility		$629.00	$1,120.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,197.00 / $1,553.02 / $3,027.26	Professional		$1,197.00	$1,553.02	$3,027.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $926.43 / $926.43 / $1,109.93	Professional		$926.43	$926.43	$1,109.93