Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,963.20 / $16,368.00 / $25,132.80	Facility		$4,963.20	$16,368.00	$25,132.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,963.20 / $4,963.20 / $19,395.20	Professional		$4,963.20	$4,963.20	$19,395.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,696.00 / $5,776.32 / $16,720.00	Facility		$3,696.00	$5,776.32	$16,720.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,148.40 / $3,168.00 / $6,877.23	Professional		$1,148.40	$3,168.00	$6,877.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,660.80 / $7,207.20 / $9,089.08	Facility		$3,660.80	$7,207.20	$9,089.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,044.92 / $4,044.92 / $5,056.14	Professional		$4,044.92	$4,044.92	$5,056.14
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,168.00 / $3,872.00 / $6,160.00	Facility		$3,168.00	$3,872.00	$6,160.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,520.00 / $5,280.00 / $9,680.00	Facility		$3,520.00	$5,280.00	$9,680.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,992.00 / $3,696.00 / $4,998.39	Professional		$2,992.00	$3,696.00	$4,998.39
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,696.00 / $5,776.32 / $9,680.00	Facility		$3,696.00	$5,776.32	$9,680.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,640.00 / $3,520.00 / $9,498.46	Professional		$2,640.00	$3,520.00	$9,498.46
United Facility/Professional Professional Modifier Low / Median / High Price $1,478.40 / $1,478.40 / $3,520.00	Professional		$1,478.40	$1,478.40	$3,520.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,584.00 / $1,584.00 / $1,823.36	Professional		$1,584.00	$1,584.00	$1,823.36