Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,301.65 / $5,578.06 / $13,491.60	Facility		$2,301.65	$5,578.06	$13,491.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $600.00 / $2,289.40 / $2,375.10	Professional		$600.00	$2,289.40	$2,375.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,355.57 / $1,355.57 / $1,355.57	Professional		$1,355.57	$1,355.57	$1,355.57
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,570.98 / $3,917.70 / $10,115.98	Facility		$2,570.98	$3,917.70	$10,115.98
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,203.69 / $4,784.33 / $18,364.20	Professional		$2,203.69	$4,784.33	$18,364.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,328.34 / $3,947.07 / $6,322.47	Facility		$1,328.34	$3,947.07	$6,322.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,169.63 / $2,588.81 / $3,465.60	Professional		$1,169.63	$2,588.81	$3,465.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,448.56 / $3,060.70 / $8,380.31	Facility		$2,448.56	$3,060.70	$8,380.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,448.56 / $3,599.38 / $7,573.55	Professional		$2,448.56	$3,599.38	$7,573.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $2,397.14 / $2,598.34	Professional		$75.00	$2,397.14	$2,598.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,448.56 / $2,448.56 / $3,672.84	Facility		$2,448.56	$2,448.56	$3,672.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,448.56 / $4,284.97 / $7,345.68	Facility		$2,448.56	$4,284.97	$7,345.68
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,203.69 / $3,060.70 / $3,697.33	Professional		$2,203.69	$3,060.70	$3,697.33
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,570.98 / $3,917.70 / $6,733.54	Facility		$2,570.98	$3,917.70	$6,733.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,708.11 / $4,764.70 / $5,693.54	Professional		$2,708.11	$4,764.70	$5,693.54
United Facility/Professional Professional Modifier Low / Median / High Price $1,028.40 / $1,028.40 / $2,742.39	Professional		$1,028.40	$1,028.40	$2,742.39