Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,782.53 / $6,316.34 / $6,594.60	Facility		$2,782.53	$6,316.34	$6,594.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,217.51 / $2,782.53 / $6,594.60	Professional		$2,217.51	$2,782.53	$6,594.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $3,211.33 / $3,211.33 / $3,282.44	Professional		$3,211.33	$3,211.33	$3,282.44
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,749.27 / $8,153.77 / $20,504.11	Facility		$3,749.27	$8,153.77	$20,504.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,049.13 / $3,747.06 / $22,086.40	Professional		$3,049.13	$3,747.06	$22,086.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,448.80 / $2,448.80 / $2,448.80	Facility		$2,448.80	$2,448.80	$2,448.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,787.62 / $1,787.62 / $2,448.80	Professional		$1,787.62	$1,787.62	$2,448.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,465.64 / $4,281.77 / $11,220.93	Facility		$2,465.64	$4,281.77	$11,220.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,468.35 / $4,333.57 / $8,315.54	Professional		$2,468.35	$4,333.57	$8,315.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,954.19 / $3,282.44 / $3,610.68	Professional		$2,954.19	$3,282.44	$3,610.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,398.78 / $4,181.42 / $4,435.02	Facility		$3,398.78	$4,181.42	$4,435.02
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,853.59 / $4,281.77 / $4,435.02	Professional		$3,853.59	$4,281.77	$4,435.02
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,749.27 / $4,808.63 / $8,362.84	Facility		$3,749.27	$4,808.63	$8,362.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,075.46 / $4,181.42 / $4,181.42	Facility		$4,075.46	$4,181.42	$4,181.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,401.49 / $3,639.50 / $4,709.95	Professional		$3,401.49	$3,639.50	$4,709.95
United Facility/Professional Professional Modifier Low / Median / High Price $1,955.12 / $2,860.96 / $3,730.12	Professional		$1,955.12	$2,860.96	$3,730.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,365.44 / $2,365.44 / $2,635.75	Professional		$2,365.44	$2,365.44	$2,635.75