Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,525.19 / $7,761.21 / $21,917.86	Facility		$3,525.19	$7,761.21	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,632.97 / $3,525.19 / $7,761.21	Professional		$2,632.97	$3,525.19	$7,761.21
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,838.34 / $15,127.44 / $28,937.08	Facility		$3,838.34	$15,127.44	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,838.34 / $6,140.52 / $32,079.30	Professional		$3,838.34	$6,140.52	$32,079.30
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 $2,811.31 / $5,037.82 / $8,469.04	Professional		$2,811.31	$5,037.82	$8,469.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,744.49 / $5,310.41 / $7,699.96	Facility		$2,744.49	$5,310.41	$7,699.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,686.87 / $5,167.76 / $7,105.74	Professional		$2,686.87	$5,167.76	$7,105.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $328.05 / $1,553.31 / $5,423.54	Professional		$328.05	$1,553.31	$5,423.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,871.98 / $5,253.68 / $5,627.33	Facility		$3,871.98	$5,253.68	$5,627.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,758.99 / $3,758.99 / $3,838.34	Facility		$3,758.99	$3,758.99	$3,838.34
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,310.27 / $6,140.52 / $7,618.73	Professional		$4,310.27	$6,140.52	$7,618.73
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 $3,833.68 / $5,463.38 / $7,273.53	Professional		$3,833.68	$5,463.38	$7,273.53
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 $3,354.98 / $4,612.43 / $8,099.59	Professional		$3,354.98	$4,612.43	$8,099.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,320.90 / $2,320.90 / $2,966.49	Professional		$2,320.90	$2,320.90	$2,966.49