Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,669.87 / $4,796.28 / $20,093.09	Facility		$2,669.87	$4,796.28	$20,093.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,530.03 / $2,188.42 / $4,642.43	Professional		$1,530.03	$2,188.42	$4,642.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,317.90 / $15,127.44 / $28,937.08	Facility		$2,317.90	$15,127.44	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,385.87 / $3,720.72 / $14,973.86	Professional		$2,385.87	$3,720.72	$14,973.86
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 $1,753.94 / $3,197.85 / $5,163.39	Professional		$1,753.94	$3,197.85	$5,163.39
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,669.66 / $3,387.15 / $4,829.62	Facility		$1,669.66	$3,387.15	$4,829.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,669.66 / $3,375.48 / $4,393.97	Professional		$1,669.66	$3,375.48	$4,393.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $197.37 / $1,046.05 / $3,300.99	Professional		$197.37	$1,046.05	$3,300.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,351.28 / $3,251.51 / $3,398.24	Facility		$2,351.28	$3,251.51	$3,398.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,277.67 / $2,277.67 / $2,317.90	Facility		$2,277.67	$2,277.67	$2,317.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,611.13 / $3,720.72 / $4,600.81	Professional		$2,611.13	$3,720.72	$4,600.81
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 $2,322.94 / $3,299.23 / $4,408.02	Professional		$2,322.94	$3,299.23	$4,408.02
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 $2,026.01 / $2,816.94 / $4,906.68	Professional		$2,026.01	$2,816.94	$4,906.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,410.98 / $1,410.98 / $1,833.58	Professional		$1,410.98	$1,410.98	$1,833.58