Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,086.73 / $5,128.00 / $19,501.53	Facility		$2,086.73	$5,128.00	$19,501.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,506.35 / $2,086.73 / $4,394.64	Professional		$1,506.35	$2,086.73	$4,394.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,390.19 / $3,275.46 / $5,821.32	Professional		$2,390.19	$3,275.46	$5,821.32
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,265.35 / $19,823.93 / $38,781.51	Facility		$2,265.35	$19,823.93	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,348.48 / $3,678.23 / $14,431.05	Professional		$2,348.48	$3,678.23	$14,431.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $8,315.84	Facility		$714.97	$870.49	$8,315.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,730.49 / $2,945.30 / $4,983.64	Professional		$1,730.49	$2,945.30	$4,983.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,738.77 / $3,607.82 / $7,292.72	Facility		$1,738.77	$3,607.82	$7,292.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,622.79 / $3,476.50 / $6,279.70	Professional		$1,622.79	$3,476.50	$6,279.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $177.47 / $906.29 / $3,223.04	Professional		$177.47	$906.29	$3,223.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,372.58 / $3,195.23 / $3,321.19	Facility		$2,372.58	$3,195.23	$3,321.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,209.73 / $2,265.35 / $10,471.91	Facility		$2,209.73	$2,265.35	$10,471.91
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,529.94 / $3,609.72 / $4,496.49	Professional		$2,529.94	$3,609.72	$4,496.49
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,793.48 / $20,262.22 / $38,781.51	Facility		$14,793.48	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,253.64 / $3,240.71 / $4,292.76	Professional		$2,253.64	$3,240.71	$4,292.76
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $5,547.00 / $19,271.00	Facility		$3,028.00	$5,547.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,009.50 / $2,671.19 / $4,754.14	Professional		$2,009.50	$2,671.19	$4,754.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,379.79 / $1,379.79 / $1,770.52	Professional		$1,379.79	$1,379.79	$1,770.52