Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,970.58 / $13,633.00 / $32,045.80	Facility		$1,970.58	$13,633.00	$32,045.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $931.51 / $1,496.94 / $5,699.72	Professional		$931.51	$1,496.94	$5,699.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $379.94 / $1,904.90 / $2,793.71	Professional		$379.94	$1,904.90	$2,793.71
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6,526.97 / $19,913.50 / $38,781.51	Facility		$6,526.97	$19,913.50	$38,781.51
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $1,134.79 / $1,887.52 / $1,887.52	Facility	AS	$1,134.79	$1,887.52	$1,887.52
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,517.51 / $2,472.00 / $9,373.28	Professional		$1,517.51	$2,472.00	$9,373.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,005.16 / $1,753.00 / $8,315.84	Facility		$1,005.16	$1,753.00	$8,315.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,125.83 / $1,921.37 / $3,251.13	Professional		$1,125.83	$1,921.37	$3,251.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,137.01 / $2,315.79 / $7,292.72	Facility		$1,137.01	$2,315.79	$7,292.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,060.41 / $2,238.00 / $6,279.70	Professional		$1,060.41	$2,238.00	$6,279.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.51 / $630.33 / $2,100.76	Professional		$116.51	$630.33	$2,100.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,490.09 / $2,059.58 / $2,161.42	Facility		$1,490.09	$2,059.58	$2,161.42
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,436.46 / $1,474.28 / $6,526.97	Facility		$1,436.46	$1,474.28	$6,526.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,646.73 / $2,346.54 / $2,926.30	Professional		$1,646.73	$2,346.54	$2,926.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,146.66 / $20,262.22 / $38,781.51	Facility		$13,146.66	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,465.00 / $2,105.30 / $2,820.40	Professional		$1,465.00	$2,105.30	$2,820.40
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 $1,315.50 / $1,743.32 / $3,094.42	Professional		$1,315.50	$1,743.32	$3,094.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $896.39 / $896.39 / $1,156.13	Professional		$896.39	$896.39	$1,156.13