Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,301.28 / $4,771.21 / $22,024.00	Facility		$2,301.28	$4,771.21	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,779.77 / $2,301.28 / $5,242.09	Professional		$1,779.77	$2,301.28	$5,242.09
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,497.51 / $18,220.34 / $35,644.43	Facility		$2,497.51	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,570.73 / $3,981.94 / $18,361.93	Professional		$2,570.73	$3,981.94	$18,361.93
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 $1,959.12 / $3,285.53 / $5,492.58	Professional		$1,959.12	$3,285.53	$5,492.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,874.49 / $3,650.01 / $5,010.75	Facility		$1,874.49	$3,650.01	$5,010.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,752.10 / $3,519.19 / $4,607.64	Professional		$1,752.10	$3,519.19	$4,607.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $217.63 / $1,061.85 / $3,511.09	Professional		$217.63	$1,061.85	$3,511.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,580.83 / $3,526.88 / $3,661.55	Facility		$2,580.83	$3,526.88	$3,661.55
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,437.59 / $2,437.59 / $2,497.51	Facility		$2,437.59	$2,437.59	$2,497.51
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,790.96 / $3,981.94 / $4,957.30	Professional		$2,790.96	$3,981.94	$4,957.30
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 $2,486.02 / $3,554.87 / $4,732.68	Professional		$2,486.02	$3,554.87	$4,732.68
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 $2,263.53 / $3,046.17 / $5,244.59	Professional		$2,263.53	$3,046.17	$5,244.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,520.30 / $1,520.30 / $1,949.16	Professional		$1,520.30	$1,520.30	$1,949.16