Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,589.56 / $5,453.38 / $22,024.00	Facility		$2,589.56	$5,453.38	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,997.08 / $2,589.56 / $5,999.83	Professional		$1,997.08	$2,589.56	$5,999.83
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,812.38 / $18,220.34 / $35,644.43	Facility		$2,812.38	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,894.84 / $4,507.81 / $19,192.43	Professional		$2,894.84	$4,507.81	$19,192.43
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 $2,209.79 / $3,734.62 / $6,176.62	Professional		$2,209.79	$3,734.62	$6,176.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,090.69 / $3,919.63 / $5,669.83	Facility		$2,090.69	$3,919.63	$5,669.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,978.46 / $3,901.41 / $5,184.43	Professional		$1,978.46	$3,901.41	$5,184.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $217.63 / $1,154.93 / $3,981.73	Professional		$217.63	$1,154.93	$3,981.73
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,944.31 / $3,974.00 / $4,123.18	Facility		$2,944.31	$3,974.00	$4,123.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,750.16 / $2,750.16 / $2,812.38	Facility		$2,750.16	$2,750.16	$2,812.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,144.97 / $4,492.54 / $5,582.29	Professional		$3,144.97	$4,492.54	$5,582.29
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,233.34 / $18,633.84 / $35,644.43	Facility		$14,233.34	$18,633.84	$35,644.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,804.80 / $4,003.06 / $5,330.33	Professional		$2,804.80	$4,003.06	$5,330.33
United Facility/Professional Facility Modifier Low / Median / High Price $2,853.00 / $5,643.00 / $19,271.00	Facility		$2,853.00	$5,643.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,502.36 / $3,402.29 / $5,888.01	Professional		$2,502.36	$3,402.29	$5,888.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,710.79 / $1,710.79 / $2,185.17	Professional		$1,710.79	$1,710.79	$2,185.17