Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,458.62 / $7,125.02 / $22,024.00	Facility		$3,458.62	$7,125.02	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,477.12 / $3,458.62 / $7,851.60	Professional		$2,477.12	$3,458.62	$7,851.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,756.54 / $46,149.28 / $90,281.73	Facility		$3,756.54	$46,149.28	$90,281.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,866.69 / $6,347.30 / $23,932.65	Professional		$3,866.69	$6,347.30	$23,932.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $765.00 / $870.49 / $870.49	Facility		$765.00	$870.49	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,756.04 / $4,881.76 / $8,250.62	Professional		$2,756.04	$4,881.76	$8,250.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,453.03 / $4,819.97 / $7,565.45	Facility		$2,453.03	$4,819.97	$7,565.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,453.03 / $4,695.72 / $6,923.45	Professional		$2,453.03	$4,695.72	$6,923.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $294.66 / $1,580.53 / $5,325.20	Professional		$294.66	$1,580.53	$5,325.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,859.47 / $5,226.89 / $5,507.40	Facility		$3,859.47	$5,226.89	$5,507.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,672.92 / $3,672.92 / $3,756.54	Facility		$3,672.92	$3,672.92	$3,756.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,199.29 / $5,999.92 / $7,456.36	Professional		$4,199.29	$5,999.92	$7,456.36
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $36,050.80 / $47,196.58 / $90,281.73	Facility		$36,050.80	$47,196.58	$90,281.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,745.90 / $5,346.95 / $7,118.55	Professional		$3,745.90	$5,346.95	$7,118.55
United Facility/Professional Facility Modifier Low / Median / High Price $3,700.00 / $7,614.00 / $24,236.00	Facility		$3,700.00	$7,614.00	$24,236.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,102.05 / $4,495.14 / $7,874.46	Professional		$3,102.05	$4,495.14	$7,874.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,285.01 / $2,285.01 / $2,919.16	Professional		$2,285.01	$2,285.01	$2,919.16