Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,718.48 / $4,500.00 / $19,919.00	Facility		$2,718.48	$4,500.00	$19,919.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,328.43 / $1,991.92 / $4,220.64	Professional		$1,328.43	$1,991.92	$4,220.64
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,072.92 / $14,476.40 / $28,937.08	Facility		$2,072.92	$14,476.40	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,171.84 / $3,379.41 / $13,677.74	Professional		$2,171.84	$3,379.41	$13,677.74
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 $1,620.85 / $2,911.69 / $4,703.60	Professional		$1,620.85	$2,911.69	$4,703.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,519.62 / $3,014.03 / $4,395.62	Facility		$1,519.62	$3,014.03	$4,395.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,519.62 / $2,988.40 / $3,969.36	Professional		$1,519.62	$2,988.40	$3,969.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $902.57 / $3,048.26	Professional		$157.37	$902.57	$3,048.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,195.00 / $3,010.31 / $3,098.08	Facility		$2,195.00	$3,010.31	$3,098.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,771.02 / $2,072.92 / $5,317.93	Facility		$1,771.02	$2,072.92	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,375.30 / $3,386.24 / $4,188.08	Professional		$2,375.30	$3,386.24	$4,188.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,038.25 / $15,118.79 / $28,937.08	Facility		$11,038.25	$15,118.79	$28,937.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,114.11 / $3,003.26 / $4,009.86	Professional		$2,114.11	$3,003.26	$4,009.86
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 $1,834.48 / $2,471.15 / $4,448.08	Professional		$1,834.48	$2,471.15	$4,448.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,284.82 / $1,284.82 / $1,670.68	Professional		$1,284.82	$1,284.82	$1,670.68