Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,102.23 / $7,130.03 / $21,917.86	Facility		$3,102.23	$7,130.03	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,349.88 / $3,102.23 / $7,130.03	Professional		$2,349.88	$3,102.23	$7,130.03
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,000.00 / $18,623.18 / $35,644.43	Facility		$2,000.00	$18,623.18	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,517.70 / $5,648.76 / $21,015.53	Professional		$3,517.70	$5,648.76	$21,015.53
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 $2,650.91 / $4,481.46 / $7,353.84	Professional		$2,650.91	$4,481.46	$7,353.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,426.90 / $4,955.04 / $6,784.43	Facility		$2,426.90	$4,955.04	$6,784.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,367.40 / $4,777.43 / $6,255.07	Professional		$2,367.40	$4,777.43	$6,255.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $292.86 / $1,355.30 / $4,697.35	Professional		$292.86	$1,355.30	$4,697.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,500.03 / $4,735.76 / $4,891.00	Facility		$3,500.03	$4,735.76	$4,891.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,296.48 / $3,336.10 / $10,581.24	Facility		$3,296.48	$3,336.10	$10,581.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,769.75 / $5,384.98 / $6,621.83	Professional		$3,769.75	$5,384.98	$6,621.83
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 $3,361.97 / $4,749.97 / $6,357.46	Professional		$3,361.97	$4,749.97	$6,357.46
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $4,016.00 / $16,315.00	Facility		$2,912.00	$4,016.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,981.58 / $4,035.34 / $7,083.87	Professional		$2,981.58	$4,035.34	$7,083.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,023.85 / $2,023.85 / $2,587.60	Professional		$2,023.85	$2,023.85	$2,587.60