Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,102.60 / $7,920.26 / $22,024.00	Facility		$4,102.60	$7,920.26	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,998.97 / $4,102.60 / $8,896.91	Professional		$2,998.97	$4,102.60	$8,896.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,458.95 / $46,149.28 / $90,281.73	Facility		$4,458.95	$46,149.28	$90,281.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,589.68 / $7,386.82 / $28,407.83	Professional		$4,589.68	$7,386.82	$28,407.83
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 $3,281.37 / $5,852.97 / $9,786.14	Professional		$3,281.37	$5,852.97	$9,786.14
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,111.47 / $6,044.22 / $9,000.17	Facility		$3,111.47	$6,044.22	$9,000.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,111.47 / $6,026.48 / $8,217.42	Professional		$3,111.47	$6,026.48	$8,217.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $371.10 / $1,866.13 / $6,297.13	Professional		$371.10	$1,866.13	$6,297.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,367.28 / $6,039.38 / $6,537.19	Facility		$4,367.28	$6,039.38	$6,537.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,364.66 / $4,364.66 / $4,458.95	Facility		$4,364.66	$4,364.66	$4,458.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,987.97 / $7,129.90 / $8,850.57	Professional		$4,987.97	$7,129.90	$8,850.57
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 $4,451.37 / $6,346.73 / $8,459.28	Professional		$4,451.37	$6,346.73	$8,459.28
United Facility/Professional Facility Modifier Low / Median / High Price $3,340.00 / $8,600.00 / $24,236.00	Facility		$3,340.00	$8,600.00	$24,236.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,882.49 / $5,209.04 / $9,373.08	Professional		$3,882.49	$5,209.04	$9,373.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,712.36 / $2,712.36 / $3,457.70	Professional		$2,712.36	$2,712.36	$3,457.70