Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,278.39 / $5,128.00 / $20,680.40	Facility		$2,278.39	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,341.62 / $2,278.39 / $4,328.93	Professional		$1,341.62	$2,278.39	$4,328.93
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,435.35 / $10,406.46 / $19,848.13	Facility		$2,435.35	$10,406.46	$19,848.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,428.73 / $4,184.26 / $15,444.53	Professional		$2,428.73	$4,184.26	$15,444.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $796.68 / $1,285.00 / $4,636.17	Facility		$796.68	$1,285.00	$4,636.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,017.64 / $3,052.88 / $5,376.19	Professional		$2,017.64	$3,052.88	$5,376.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,197.00 / $3,286.76 / $4,902.25	Facility		$2,197.00	$3,286.76	$4,902.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,219.80 / $3,326.71 / $4,966.64	Professional		$2,219.80	$3,326.71	$4,966.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $175.12 / $897.79 / $3,487.19	Professional		$175.12	$897.79	$3,487.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,215.13 / $3,063.24 / $3,570.43	Facility		$2,215.13	$3,063.24	$3,570.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,313.10 / $2,381.42 / $2,435.35	Facility		$1,313.10	$2,381.42	$2,435.35
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,461.58 / $4,041.90 / $4,833.93	Professional		$2,461.58	$4,041.90	$4,833.93
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 $2,400.35 / $3,274.67 / $4,597.42	Professional		$2,400.35	$3,274.67	$4,597.42
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 $2,114.37 / $2,681.64 / $5,128.74	Professional		$2,114.37	$2,681.64	$5,128.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,916.33 / $1,916.33 / $1,916.33	Professional		$1,916.33	$1,916.33	$1,916.33