Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,318.79 / $12,619.36 / $25,612.66	Facility		$1,318.79	$12,619.36	$25,612.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,156.91 / $1,318.79 / $1,447.18	Professional		$1,156.91	$1,318.79	$1,447.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $12,154.00 / $20,262.22 / $38,781.51	Facility		$12,154.00	$20,262.22	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,745.19 / $2,978.79 / $11,641.05	Professional		$1,745.19	$2,978.79	$11,641.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $2,000.00	Facility		$714.97	$870.49	$2,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $740.15 / $740.15 / $886.78	Professional		$740.15	$740.15	$886.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,945.24 / $6,164.44 / $26,311.49	Facility		$3,945.24	$6,164.44	$26,311.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,873.44 / $5,065.67 / $7,000.76	Professional		$3,873.44	$5,065.67	$7,000.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,684.17 / $2,405.94 / $6,959.47	Facility		$1,684.17	$2,405.94	$6,959.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,704.19 / $1,704.19 / $1,822.97	Facility		$1,704.19	$1,704.19	$1,822.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,933.43 / $2,824.61 / $3,618.42	Professional		$1,933.43	$2,824.61	$3,618.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,146.66 / $20,262.22 / $38,781.51	Facility		$13,146.66	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,738.04 / $2,491.25 / $3,454.47	Professional		$1,738.04	$2,491.25	$3,454.47
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,129.00 / $11,941.00	Facility		$2,155.00	$3,129.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,618.09 / $2,220.17 / $4,518.02	Professional		$1,618.09	$2,220.17	$4,518.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,536.92 / $1,536.92 / $1,536.92	Professional		$1,536.92	$1,536.92	$1,536.92