Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,085.67 / $5,128.00 / $21,917.86	Facility		$2,085.67	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,545.73 / $2,085.67 / $4,955.18	Professional		$1,545.73	$2,085.67	$4,955.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,203.85 / $16,586.25 / $31,745.76	Facility		$2,203.85	$16,586.25	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,292.25 / $3,600.10 / $16,240.27	Professional		$2,292.25	$3,600.10	$16,240.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $8,758.29	Facility		$714.97	$870.49	$8,758.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,716.14 / $3,009.43 / $4,978.85	Professional		$1,716.14	$3,009.43	$4,978.85
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,700.25 / $3,491.18 / $7,680.74	Facility		$1,700.25	$3,491.18	$7,680.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,643.60 / $3,435.77 / $6,613.82	Professional		$1,643.60	$3,435.77	$6,613.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $189.74 / $905.72 / $3,201.52	Professional		$189.74	$905.72	$3,201.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,429.28 / $3,191.29 / $3,361.80	Facility		$2,429.28	$3,191.29	$3,361.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,771.02 / $2,203.85 / $5,317.93	Facility		$1,771.02	$2,203.85	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,527.38 / $3,600.10 / $4,468.37	Professional		$2,527.38	$3,600.10	$4,468.37
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,761.59 / $16,586.25 / $31,745.76	Facility		$10,761.59	$16,586.25	$31,745.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,247.63 / $3,204.26 / $4,265.92	Professional		$2,247.63	$3,204.26	$4,265.92
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 $1,986.60 / $2,736.82 / $4,749.29	Professional		$1,986.60	$2,736.82	$4,749.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,359.36 / $1,359.36 / $1,750.12	Professional		$1,359.36	$1,359.36	$1,750.12