Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,462.52 / $5,381.97 / $21,917.86	Facility		$2,462.52	$5,381.97	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,943.27 / $2,462.52 / $5,381.97	Professional		$1,943.27	$2,462.52	$5,381.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,666.14 / $15,127.44 / $28,937.08	Facility		$2,666.14	$15,127.44	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,744.31 / $4,261.66 / $19,633.29	Professional		$2,744.31	$4,261.66	$19,633.29
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 $2,125.73 / $3,655.38 / $5,892.81	Professional		$2,125.73	$3,655.38	$5,892.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,997.19 / $3,910.18 / $5,362.26	Facility		$1,997.19	$3,910.18	$5,362.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,895.36 / $3,770.03 / $4,948.45	Professional		$1,895.36	$3,770.03	$4,948.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $197.99 / $1,154.71 / $3,826.72	Professional		$197.99	$1,154.71	$3,826.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,958.13 / $3,754.68 / $4,044.79	Facility		$2,958.13	$3,754.68	$4,044.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,608.83 / $2,608.83 / $2,666.14	Facility		$2,608.83	$2,608.83	$2,666.14
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,992.37 / $4,261.66 / $5,292.02	Professional		$2,992.37	$4,261.66	$5,292.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,555.00 / $15,127.44 / $28,937.08	Facility		$11,555.00	$15,127.44	$28,937.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,660.66 / $3,794.90 / $5,052.24	Professional		$2,660.66	$3,794.90	$5,052.24
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 $2,409.71 / $3,141.85 / $5,547.95	Professional		$2,409.71	$3,141.85	$5,547.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,611.13 / $1,611.13 / $2,070.23	Professional		$1,611.13	$1,611.13	$2,070.23