Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,131.10 / $7,483.40 / $21,917.86	Facility		$3,131.10	$7,483.40	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,292.40 / $3,131.10 / $7,483.40	Professional		$2,292.40	$3,131.10	$7,483.40
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,377.69 / $15,127.44 / $28,937.08	Facility		$3,377.69	$15,127.44	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,439.55 / $5,382.03 / $23,227.73	Professional		$3,439.55	$5,382.03	$23,227.73
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 $2,493.17 / $4,420.63 / $7,435.92	Professional		$2,493.17	$4,420.63	$7,435.92
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,369.64 / $4,462.07 / $6,854.37	Facility		$2,369.64	$4,462.07	$6,854.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,369.64 / $4,433.52 / $6,269.18	Professional		$2,369.64	$4,433.52	$6,269.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $293.45 / $1,372.93 / $4,845.66	Professional		$293.45	$1,372.93	$4,845.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,758.30 / $4,784.47 / $4,977.60	Facility		$3,758.30	$4,784.47	$4,977.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,315.96 / $3,315.96 / $3,377.69	Facility		$3,315.96	$3,315.96	$3,377.69
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,792.36 / $5,416.80 / $6,704.38	Professional		$3,792.36	$5,416.80	$6,704.38
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 $3,381.84 / $4,807.70 / $6,418.24	Professional		$3,381.84	$4,807.70	$6,418.24
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 $2,920.00 / $4,059.54 / $7,147.04	Professional		$2,920.00	$4,059.54	$7,147.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,055.87 / $2,055.87 / $2,633.99	Professional		$2,055.87	$2,055.87	$2,633.99