Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,961.00 / $4,758.93 / $22,024.00	Facility		$2,961.00	$4,758.93	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,483.69 / $2,080.03 / $4,376.12	Professional		$1,483.69	$2,080.03	$4,376.12
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,163.53 / $15,118.40 / $28,937.08	Facility		$2,163.53	$15,118.40	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,268.27 / $3,527.81 / $14,308.48	Professional		$2,268.27	$3,527.81	$14,308.48
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 $1,762.46 / $3,041.22 / $4,914.56	Professional		$1,762.46	$3,041.22	$4,914.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,584.72 / $3,187.80 / $4,583.93	Facility		$1,584.72	$3,187.80	$4,583.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,584.72 / $3,142.96 / $4,145.14	Professional		$1,584.72	$3,142.96	$4,145.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $909.40 / $3,206.47	Professional		$157.37	$909.40	$3,206.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,333.84 / $3,176.46 / $3,247.68	Facility		$2,333.84	$3,176.46	$3,247.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,771.02 / $2,163.53 / $5,317.93	Facility		$1,771.02	$2,163.53	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,479.60 / $3,534.24 / $4,374.04	Professional		$2,479.60	$3,534.24	$4,374.04
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 $2,206.51 / $3,136.61 / $4,185.16	Professional		$2,206.51	$3,136.61	$4,185.16
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 $1,969.38 / $2,590.85 / $4,633.91	Professional		$1,969.38	$2,590.85	$4,633.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,341.96 / $1,341.96 / $1,745.86	Professional		$1,341.96	$1,341.96	$1,745.86