Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,254.73 / $7,491.28 / $21,917.86	Facility		$3,254.73	$7,491.28	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,574.46 / $3,254.73 / $7,491.28	Professional		$2,574.46	$3,254.73	$7,491.28
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,539.92 / $15,127.44 / $28,937.08	Facility		$3,539.92	$15,127.44	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,643.72 / $5,673.95 / $27,619.68	Professional		$3,643.72	$5,673.95	$27,619.68
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 $2,642.73 / $4,646.64 / $7,813.17	Professional		$2,642.73	$4,646.64	$7,813.17
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,642.15 / $5,085.18 / $7,105.45	Facility		$2,642.15	$5,085.18	$7,105.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,456.44 / $4,981.41 / $6,556.20	Professional		$2,456.44	$4,981.41	$6,556.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $293.68 / $1,440.09 / $4,970.56	Professional		$293.68	$1,440.09	$4,970.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,755.62 / $4,997.53 / $5,189.82	Facility		$3,755.62	$4,997.53	$5,189.82
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,466.36 / $3,466.36 / $3,539.92	Facility		$3,466.36	$3,466.36	$3,539.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,974.24 / $5,662.48 / $7,026.40	Professional		$3,974.24	$5,662.48	$7,026.40
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 $3,535.22 / $5,038.62 / $6,708.04	Professional		$3,535.22	$5,038.62	$6,708.04
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 $3,094.14 / $4,254.24 / $7,468.13	Professional		$3,094.14	$4,254.24	$7,468.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,140.63 / $2,140.63 / $2,738.75	Professional		$2,140.63	$2,140.63	$2,738.75