Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,290.46 / $5,757.04 / $21,917.86	Facility		$2,290.46	$5,757.04	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,806.10 / $2,290.46 / $5,659.05	Professional		$1,806.10	$2,290.46	$5,659.05
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,424.46 / $15,118.79 / $28,937.08	Facility		$2,424.46	$15,118.79	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,549.57 / $3,935.06 / $18,236.43	Professional		$2,549.57	$3,935.06	$18,236.43
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 $1,952.79 / $3,396.18 / $5,474.96	Professional		$1,952.79	$3,396.18	$5,474.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,977.52 / $3,567.02 / $4,846.66	Facility		$1,977.52	$3,567.02	$4,846.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,763.52 / $3,412.26 / $4,534.53	Professional		$1,763.52	$3,412.26	$4,534.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $194.47 / $990.68 / $3,497.46	Professional		$194.47	$990.68	$3,497.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,815.91 / $3,511.06 / $3,894.04	Facility		$2,815.91	$3,511.06	$3,894.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,771.02 / $2,424.46 / $5,317.93	Facility		$1,771.02	$2,424.46	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,781.20 / $3,960.48 / $4,916.47	Professional		$2,781.20	$3,960.48	$4,916.47
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 $2,472.62 / $3,525.60 / $4,693.72	Professional		$2,472.62	$3,525.60	$4,693.72
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 $2,217.16 / $2,977.14 / $5,155.93	Professional		$2,217.16	$2,977.14	$5,155.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,496.01 / $1,496.01 / $1,922.71	Professional		$1,496.01	$1,496.01	$1,922.71