Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,594.35 / $5,057.95 / $22,024.00	Facility		$2,594.35	$5,057.95	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,989.01 / $2,594.35 / $5,606.25	Professional		$1,989.01	$2,594.35	$5,606.25
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,817.86 / $18,220.34 / $35,644.43	Facility		$2,817.86	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,978.84 / $4,721.03 / $18,246.50	Professional		$2,978.84	$4,721.03	$18,246.50
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 $2,213.58 / $3,662.55 / $6,189.18	Professional		$2,213.58	$3,662.55	$6,189.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,118.75 / $4,143.84 / $5,679.69	Facility		$2,118.75	$4,143.84	$5,679.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,981.90 / $3,995.32 / $5,231.05	Professional		$1,981.90	$3,995.32	$5,231.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $217.63 / $1,157.95 / $3,973.56	Professional		$217.63	$1,157.95	$3,973.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,875.81 / $3,982.58 / $4,131.22	Facility		$2,875.81	$3,982.58	$4,131.22
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,755.15 / $2,755.15 / $2,817.86	Facility		$2,755.15	$2,755.15	$2,817.86
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,150.62 / $4,500.68 / $5,593.18	Professional		$3,150.62	$4,500.68	$5,593.18
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 $2,809.88 / $4,010.86 / $5,339.76	Professional		$2,809.88	$4,010.86	$5,339.76
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $5,547.00 / $19,271.00	Facility		$3,028.00	$5,547.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,463.01 / $3,449.13 / $5,920.44	Professional		$2,463.01	$3,449.13	$5,920.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,714.38 / $1,714.38 / $2,190.31	Professional		$1,714.38	$1,714.38	$2,190.31