Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,585.48 / $8,151.11 / $21,917.86	Facility		$3,585.48	$8,151.11	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,619.19 / $3,585.48 / $8,151.11	Professional		$2,619.19	$3,585.48	$8,151.11
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 $4,105.00 / $6,527.21 / $24,819.98	Professional		$4,105.00	$6,527.21	$24,819.98
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 $2,995.86 / $5,062.17 / $8,553.76	Professional		$2,995.86	$5,062.17	$8,553.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,773.75 / $5,413.69 / $7,865.85	Facility		$2,773.75	$5,413.69	$7,865.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,719.32 / $5,392.68 / $7,178.99	Professional		$2,719.32	$5,392.68	$7,178.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $294.66 / $1,597.02 / $5,474.10	Professional		$294.66	$1,597.02	$5,474.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,032.01 / $5,506.29 / $5,711.75	Facility		$4,032.01	$5,506.29	$5,711.75
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,523.84 / $3,810.64 / $10,581.24	Facility		$3,523.84	$3,810.64	$10,581.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,356.00 / $6,224.88 / $7,733.03	Professional		$4,356.00	$6,224.88	$7,733.03
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 $3,886.34 / $5,545.34 / $7,386.35	Professional		$3,886.34	$5,545.34	$7,386.35
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 $3,437.99 / $4,662.89 / $8,185.52	Professional		$3,437.99	$4,662.89	$8,185.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,371.14 / $2,371.14 / $3,025.95	Professional		$2,371.14	$2,371.14	$3,025.95