Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,908.20 / $4,500.00 / $18,711.00	Facility		$1,908.20	$4,500.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,184.50 / $1,563.08 / $3,728.75	Professional		$1,184.50	$1,563.08	$3,728.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,056.96 / $10,166.93 / $19,848.13	Facility		$2,056.96	$10,166.93	$19,848.13
Asuris Northwest Health Facility/Professional Facility Modifier 62 Low / Median / High Price $3,954.11 / $6,576.94 / $6,576.94	Facility	62	$3,954.11	$6,576.94	$6,576.94
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $632.66 / $1,052.31 / $1,052.31	Facility	AS	$632.66	$1,052.31	$1,052.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,056.36 / $3,721.22 / $13,131.60	Professional		$2,056.36	$3,721.22	$13,131.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $644.92 / $1,110.00 / $4,636.17	Facility		$644.92	$1,110.00	$4,636.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,696.27 / $2,516.73 / $4,503.53	Professional		$1,696.27	$2,516.73	$4,503.53
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,805.00 / $2,800.40 / $4,142.75	Facility		$1,805.00	$2,800.40	$4,142.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,837.22 / $2,916.22 / $4,240.71	Professional		$1,837.22	$2,916.22	$4,240.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $141.92 / $713.73 / $2,928.71	Professional		$141.92	$713.73	$2,928.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,080.92 / $2,806.02 / $3,015.67	Facility		$2,080.92	$2,806.02	$3,015.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,313.10 / $2,016.30 / $2,056.96	Facility		$1,313.10	$2,016.30	$2,056.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,056.96 / $3,407.31 / $4,082.86	Professional		$2,056.96	$3,407.31	$4,082.86
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,832.97 / $10,161.12 / $19,448.18	Facility		$6,832.97	$10,161.12	$19,448.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,032.33 / $2,765.86 / $3,891.82	Professional		$2,032.33	$2,765.86	$3,891.82
United Facility/Professional Facility Modifier Low / Median / High Price $1,403.00 / $2,428.00 / $11,941.00	Facility		$1,403.00	$2,428.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,864.24 / $2,267.73 / $4,317.39	Professional		$1,864.24	$2,267.73	$4,317.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,598.52 / $1,598.52 / $1,598.52	Professional		$1,598.52	$1,598.52	$1,598.52