Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $4,500.00 / $19,463.47	Facility		$1,733.00	$4,500.00	$19,463.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $971.42 / $1,355.64 / $2,872.90	Professional		$971.42	$1,355.64	$2,872.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,004.88 / $2,004.88 / $2,004.88	Professional		$2,004.88	$2,004.88	$2,004.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,433.20 / $17,574.13 / $36,111.08	Facility		$5,433.20	$17,574.13	$36,111.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,447.43 / $2,377.39 / $8,821.95	Professional		$1,447.43	$2,377.39	$8,821.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $7,318.13	Facility		$625.25	$761.81	$7,318.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,058.16 / $1,810.38 / $3,046.54	Professional		$1,058.16	$1,810.38	$3,046.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,069.84 / $2,199.46 / $6,417.76	Facility		$1,069.84	$2,199.46	$6,417.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $980.07 / $2,108.30 / $5,526.27	Professional		$980.07	$2,108.30	$5,526.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.20 / $460.26 / $2,097.61	Professional		$109.20	$460.26	$2,097.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,447.29 / $1,955.73 / $2,035.24	Facility		$1,447.29	$1,955.73	$2,035.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,355.83 / $1,384.71 / $5,433.20	Facility		$1,355.83	$1,384.71	$5,433.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,556.30 / $2,214.82 / $2,748.51	Professional		$1,556.30	$2,214.82	$2,748.51
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,241.40 / $18,867.00 / $36,111.08	Facility		$12,241.40	$18,867.00	$36,111.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,382.77 / $1,983.14 / $2,665.52	Professional		$1,382.77	$1,983.14	$2,665.52
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $4,016.00 / $16,315.00	Facility		$2,912.00	$4,016.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,227.66 / $1,637.41 / $2,888.66	Professional		$1,227.66	$1,637.41	$2,888.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $846.15 / $846.15 / $1,083.72	Professional		$846.15	$846.15	$1,083.72