Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,912.55 / $6,450.15 / $21,917.86	Facility		$2,912.55	$6,450.15	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,131.83 / $2,912.55 / $6,450.15	Professional		$2,131.83	$2,912.55	$6,450.15
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,140.50 / $15,127.44 / $28,937.08	Facility		$3,140.50	$15,127.44	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,219.20 / $5,004.10 / $21,431.33	Professional		$3,219.20	$5,004.10	$21,431.33
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 $2,481.67 / $4,112.28 / $6,915.58	Professional		$2,481.67	$4,112.28	$6,915.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,236.15 / $4,607.18 / $6,366.57	Facility		$2,236.15	$4,607.18	$6,366.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,221.59 / $4,470.78 / $5,853.56	Professional		$2,221.59	$4,470.78	$5,853.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $292.86 / $1,276.35 / $4,458.31	Professional		$292.86	$1,276.35	$4,458.31
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,126.44 / $4,308.77 / $4,604.24	Facility		$3,126.44	$4,308.77	$4,604.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,083.12 / $3,083.12 / $3,140.50	Facility		$3,083.12	$3,083.12	$3,140.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,527.24 / $5,036.43 / $6,233.59	Professional		$3,527.24	$5,036.43	$6,233.59
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 $3,144.37 / $4,470.09 / $5,966.34	Professional		$3,144.37	$4,470.09	$5,966.34
United Facility/Professional Facility Modifier Low / Median / High Price $2,240.64 / $4,135.00 / $16,315.00	Facility		$2,240.64	$4,135.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,791.50 / $3,775.75 / $6,640.07	Professional		$2,791.50	$3,775.75	$6,640.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,912.32 / $1,912.32 / $2,451.67	Professional		$1,912.32	$1,912.32	$2,451.67