Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,372.21 / $6,170.93 / $21,917.86	Facility		$3,372.21	$6,170.93	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,420.00 / $3,372.21 / $7,223.86	Professional		$2,420.00	$3,372.21	$7,223.86
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 $3,769.32 / $6,150.94 / $23,328.00	Professional		$3,769.32	$6,150.94	$23,328.00
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 $2,669.66 / $4,760.38 / $8,071.57	Professional		$2,669.66	$4,760.38	$8,071.57
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,461.40 / $4,508.89 / $7,231.75	Facility		$2,461.40	$4,508.89	$7,231.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,461.40 / $4,495.02 / $6,749.03	Professional		$2,461.40	$4,495.02	$6,749.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $292.86 / $1,515.44 / $5,196.47	Professional		$292.86	$1,515.44	$5,196.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,091.38 / $4,485.33 / $5,368.71	Facility		$3,091.38	$4,485.33	$5,368.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,523.84 / $3,564.66 / $10,581.24	Facility		$3,523.84	$3,564.66	$10,581.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,086.25 / $5,825.45 / $7,268.59	Professional		$4,086.25	$5,825.45	$7,268.59
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 $3,635.48 / $5,212.30 / $6,939.26	Professional		$3,635.48	$5,212.30	$6,939.26
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 $3,074.18 / $4,330.22 / $7,678.63	Professional		$3,074.18	$4,330.22	$7,678.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,230.90 / $2,230.90 / $2,869.29	Professional		$2,230.90	$2,230.90	$2,869.29