Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,554.94 / $5,009.76 / $6,055.21	Facility		$2,554.94	$5,009.76	$6,055.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,938.72 / $2,554.94 / $6,055.21	Professional		$1,938.72	$2,554.94	$6,055.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,948.68 / $2,948.68 / $3,013.96	Professional		$2,948.68	$2,948.68	$3,013.96
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,442.61 / $7,486.87 / $18,029.93	Facility		$3,442.61	$7,486.87	$18,029.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,580.44 / $3,440.59 / $19,461.27	Professional		$2,580.44	$3,440.59	$19,461.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,160.07 / $2,160.07 / $2,160.07	Facility		$2,160.07	$2,160.07	$2,160.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,576.85 / $1,576.85 / $2,160.07	Professional		$1,576.85	$1,576.85	$2,160.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,174.90 / $3,931.57 / $9,898.12	Facility		$2,174.90	$3,931.57	$9,898.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,177.29 / $3,931.57 / $7,334.96	Professional		$2,177.29	$3,931.57	$7,334.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,712.56 / $3,013.96 / $3,315.35	Professional		$2,712.56	$3,013.96	$3,315.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,120.76 / $3,839.42 / $3,931.57	Facility		$3,120.76	$3,839.42	$3,931.57
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,538.41 / $3,877.43 / $3,931.57	Professional		$3,538.41	$3,877.43	$3,931.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,442.61 / $4,415.33 / $7,678.84	Facility		$3,442.61	$4,415.33	$7,678.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,742.12 / $3,839.42 / $3,839.42	Facility		$3,742.12	$3,839.42	$3,839.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,123.27 / $3,341.83 / $4,324.72	Professional		$3,123.27	$3,341.83	$4,324.72
United Facility/Professional Professional Modifier Low / Median / High Price $1,724.61 / $2,597.88 / $3,290.34	Professional		$1,724.61	$2,597.88	$3,290.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,908.95 / $1,908.95 / $2,148.37	Professional		$1,908.95	$1,908.95	$2,148.37