Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,214.03 / $2,755.85 / $2,877.25	Facility		$1,214.03	$2,755.85	$2,877.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $938.85 / $1,214.03 / $2,755.85	Professional		$938.85	$1,214.03	$2,755.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,349.23 / $1,349.23 / $1,349.23	Professional		$1,349.23	$1,349.23	$1,349.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,575.24 / $3,177.18 / $8,839.16	Facility		$1,575.24	$3,177.18	$8,839.16
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,299.75 / $1,626.68 / $10,623.84	Professional		$1,299.75	$1,626.68	$10,623.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,037.25 / $1,037.25 / $1,037.25	Facility		$1,037.25	$1,037.25	$1,037.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $757.19 / $757.19 / $1,037.25	Professional		$757.19	$757.19	$1,037.25
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,319.36 / $2,068.82 / $5,071.80	Facility		$1,319.36	$2,068.82	$5,071.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,319.36 / $2,062.46 / $3,560.97	Professional		$1,319.36	$2,062.46	$3,560.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,241.19 / $1,379.11 / $1,517.02	Professional		$1,241.19	$1,379.11	$1,517.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,637.23 / $1,756.81 / $1,798.97	Facility		$1,637.23	$1,756.81	$1,798.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,493.29 / $1,575.24 / $3,425.78	Facility		$1,493.29	$1,575.24	$3,425.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,493.29 / $1,626.68 / $2,309.96	Professional		$1,493.29	$1,626.68	$2,309.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,712.29 / $1,756.81 / $1,756.81	Facility		$1,712.29	$1,756.81	$1,756.81
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,429.13 / $1,529.12 / $1,978.87	Professional		$1,429.13	$1,529.12	$1,978.87
United Facility/Professional Professional Modifier Low / Median / High Price $779.53 / $886.10 / $1,579.99	Professional		$779.53	$886.10	$1,579.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,124.88 / $1,124.88 / $1,124.88	Professional		$1,124.88	$1,124.88	$1,124.88