Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,156.94 / $5,132.00 / $22,024.00	Facility		$2,156.94	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,574.97 / $2,156.94 / $4,644.31	Professional		$1,574.97	$2,156.94	$4,644.31
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,320.19 / $15,127.44 / $28,937.08	Facility		$2,320.19	$15,127.44	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,323.40 / $3,697.58 / $17,970.61	Professional		$2,323.40	$3,697.58	$17,970.61
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 $1,700.20 / $3,041.82 / $5,116.35	Professional		$1,700.20	$3,041.82	$5,116.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,618.51 / $3,135.10 / $4,681.67	Facility		$1,618.51	$3,135.10	$4,681.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,618.51 / $3,036.07 / $4,298.60	Professional		$1,618.51	$3,036.07	$4,298.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $191.68 / $927.47 / $3,320.79	Professional		$191.68	$927.47	$3,320.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,250.78 / $3,072.62 / $3,401.59	Facility		$2,250.78	$3,072.62	$3,401.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,278.14 / $2,278.14 / $2,320.19	Facility		$2,278.14	$2,278.14	$2,320.19
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,605.98 / $3,721.46 / $4,605.35	Professional		$2,605.98	$3,721.46	$4,605.35
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 $2,323.40 / $3,302.48 / $4,403.62	Professional		$2,323.40	$3,302.48	$4,403.62
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 $2,005.00 / $2,743.61 / $4,894.56	Professional		$2,005.00	$2,743.61	$4,894.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,412.64 / $1,412.64 / $1,817.42	Professional		$1,412.64	$1,412.64	$1,817.42