Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,465.08 / $6,508.20 / $21,917.86	Facility		$3,465.08	$6,508.20	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,605.57 / $3,465.08 / $7,279.05	Professional		$2,605.57	$3,465.08	$7,279.05
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,680.17 / $18,633.84 / $35,644.43	Facility		$3,680.17	$18,633.84	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,873.74 / $6,231.01 / $23,976.53	Professional		$3,873.74	$6,231.01	$23,976.53
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 $2,755.70 / $4,891.71 / $8,266.35	Professional		$2,755.70	$4,891.71	$8,266.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,494.05 / $4,653.47 / $7,510.68	Facility		$2,494.05	$4,653.47	$7,510.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,494.05 / $4,639.80 / $6,937.17	Professional		$2,494.05	$4,639.80	$6,937.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $294.66 / $1,576.81 / $5,341.90	Professional		$294.66	$1,576.81	$5,341.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,446.65 / $4,630.68 / $5,517.45	Facility		$3,446.65	$4,630.68	$5,517.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,523.84 / $3,680.17 / $10,581.24	Facility		$3,523.84	$3,680.17	$10,581.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,207.51 / $6,011.76 / $7,469.97	Professional		$4,207.51	$6,011.76	$7,469.97
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 $3,753.29 / $5,356.70 / $7,131.51	Professional		$3,753.29	$5,356.70	$7,131.51
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 $3,185.55 / $4,538.33 / $7,906.48	Professional		$3,185.55	$4,538.33	$7,906.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,288.88 / $2,288.88 / $2,924.74	Professional		$2,288.88	$2,288.88	$2,924.74