Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,426.68 / $12,619.36 / $25,612.66	Facility		$3,426.68	$12,619.36	$25,612.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,119.76 / $3,426.68 / $3,693.75	Professional		$2,119.76	$3,426.68	$3,693.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,660.57 / $10,406.46 / $19,848.13	Facility		$3,660.57	$10,406.46	$19,848.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,500.31 / $6,279.54 / $23,376.30	Professional		$2,500.31	$6,279.54	$23,376.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $906.70 / $1,413.00 / $4,636.17	Facility		$906.70	$1,413.00	$4,636.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,056.61 / $4,618.99 / $8,067.66	Professional		$3,056.61	$4,618.99	$8,067.66
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,570.83 / $4,240.71 / $6,806.26	Facility		$2,570.83	$4,240.71	$6,806.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,930.92 / $4,458.72 / $6,862.45	Professional		$2,930.92	$4,458.72	$6,862.45
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 $3,096.32 / $5,160.53 / $5,366.70	Facility		$3,096.32	$5,160.53	$5,366.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,313.10 / $3,575.08 / $3,660.57	Facility		$1,313.10	$3,575.08	$3,660.57
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,686.92 / $6,065.89 / $7,265.87	Professional		$3,686.92	$6,065.89	$7,265.87
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 $3,603.49 / $4,922.14 / $6,905.38	Professional		$3,603.49	$4,922.14	$6,905.38
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 $3,238.20 / $4,132.81 / $7,696.98	Professional		$3,238.20	$4,132.81	$7,696.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,437.84 / $2,437.84 / $2,437.84	Professional		$2,437.84	$2,437.84	$2,437.84