Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,999.55 / $3,999.55 / $3,999.55	Facility		$3,999.55	$3,999.55	$3,999.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $961.45 / $3,999.55 / $4,380.72	Professional		$961.45	$3,999.55	$4,380.72
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,412.73 / $9,101.25 / $17,812.14	Facility		$2,412.73	$9,101.25	$17,812.14
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,502.75 / $7,385.05 / $30,035.78	Professional		$4,502.75	$7,385.05	$30,035.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $3,302.92	Facility		$714.97	$870.49	$3,302.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,398.52 / $6,903.78 / $10,417.01	Professional		$4,398.52	$6,903.78	$10,417.01
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,225.36 / $4,629.77 / $8,266.54	Facility		$2,225.36	$4,629.77	$8,266.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,225.36 / $4,506.59 / $7,677.02	Professional		$2,225.36	$4,506.59	$7,677.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,137.38 / $5,861.29 / $6,895.64	Facility		$4,137.38	$5,861.29	$6,895.64
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $803.50 / $4,178.02 / $4,703.43	Facility		$803.50	$4,178.02	$4,703.43
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,787.96 / $7,287.77 / $9,335.87	Professional		$4,787.96	$7,287.77	$9,335.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,812.14 / $9,118.81 / $17,453.22	Facility		$6,812.14	$9,118.81	$17,453.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,261.03 / $6,378.01 / $8,677.03	Professional		$4,261.03	$6,378.01	$8,677.03
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 $2,476.71 / $5,157.35 / $9,151.34	Professional		$2,476.71	$5,157.35	$9,151.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,738.52 / $1,738.52 / $1,738.52	Professional		$1,738.52	$1,738.52	$1,738.52