Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,678.21 / $5,612.13 / $21,917.86	Facility		$2,678.21	$5,612.13	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,959.82 / $2,678.21 / $5,795.06	Professional		$1,959.82	$2,678.21	$5,795.06
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,887.78 / $15,127.44 / $28,937.08	Facility		$2,887.78	$15,127.44	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,972.46 / $4,842.00 / $19,923.77	Professional		$2,972.46	$4,842.00	$19,923.77
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 $2,124.75 / $3,781.54 / $6,361.04	Professional		$2,124.75	$3,781.54	$6,361.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,020.58 / $4,101.41 / $5,844.69	Facility		$2,020.58	$4,101.41	$5,844.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,020.58 / $4,076.65 / $5,362.80	Professional		$2,020.58	$4,076.65	$5,362.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $255.53 / $1,169.03 / $4,104.88	Professional		$255.53	$1,169.03	$4,104.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,764.56 / $3,823.02 / $4,233.72	Facility		$2,764.56	$3,823.02	$4,233.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,833.97 / $2,833.97 / $2,887.78	Facility		$2,833.97	$2,833.97	$2,887.78
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,242.59 / $4,629.43 / $5,731.96	Professional		$3,242.59	$4,629.43	$5,731.96
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 $2,890.27 / $4,110.39 / $5,481.84	Professional		$2,890.27	$4,110.39	$5,481.84
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 $2,526.67 / $3,336.19 / $6,093.27	Professional		$2,526.67	$3,336.19	$6,093.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,758.83 / $1,758.83 / $2,256.77	Professional		$1,758.83	$1,758.83	$2,256.77