Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,066.13 / $10,700.00 / $22,024.00	Facility		$3,066.13	$10,700.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,896.56 / $3,066.13 / $3,305.12	Professional		$1,896.56	$3,066.13	$3,305.12
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,275.78 / $10,406.46 / $19,848.13	Facility		$3,275.78	$10,406.46	$19,848.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,237.14 / $5,617.88 / $20,918.84	Professional		$2,237.14	$5,617.88	$20,918.84
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 $2,734.84 / $4,132.71 / $7,219.60	Professional		$2,734.84	$4,132.71	$7,219.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,379.98 / $3,976.70 / $6,089.53	Facility		$2,379.98	$3,976.70	$6,089.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,930.92 / $4,240.71 / $6,140.05	Professional		$2,930.92	$4,240.71	$6,140.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $80.00	Professional		$45.00	$50.00	$80.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,770.39 / $4,617.32 / $4,802.56	Facility		$2,770.39	$4,617.32	$4,802.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,313.10 / $3,198.63 / $3,275.78	Facility		$1,313.10	$3,198.63	$3,275.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,299.10 / $5,426.74 / $6,502.09	Professional		$3,299.10	$5,426.74	$6,502.09
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 $3,224.05 / $4,404.74 / $6,178.63	Professional		$3,224.05	$4,404.74	$6,178.63
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 $2,897.58 / $3,587.48 / $6,885.96	Professional		$2,897.58	$3,587.48	$6,885.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,181.10 / $2,181.10 / $2,181.10	Professional		$2,181.10	$2,181.10	$2,181.10