Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,910.69 / $5,104.25 / $22,024.00	Facility		$2,910.69	$5,104.25	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,044.00 / $2,910.69 / $6,178.32	Professional		$2,044.00	$2,910.69	$6,178.32
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,067.38 / $16,595.73 / $31,745.76	Facility		$3,067.38	$16,595.73	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,077.38 / $4,862.79 / $24,626.21	Professional		$3,077.38	$4,862.79	$24,626.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $765.00 / $870.49	Facility		$714.97	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,297.64 / $4,036.66 / $6,826.46	Professional		$2,297.64	$4,036.66	$6,826.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,154.50 / $4,127.78 / $5,829.79	Facility		$2,154.50	$4,127.78	$5,829.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,154.50 / $4,023.88 / $5,704.59	Professional		$2,154.50	$4,023.88	$5,704.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $255.08 / $1,254.26 / $4,317.19	Professional		$255.08	$1,254.26	$4,317.19
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,721.44 / $3,796.77 / $4,497.04	Facility		$2,721.44	$3,796.77	$4,497.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,017.43 / $3,017.43 / $3,067.38	Facility		$3,017.43	$3,017.43	$3,067.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,448.11 / $4,929.14 / $6,088.46	Professional		$3,448.11	$4,929.14	$6,088.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,761.59 / $16,586.25 / $31,745.76	Facility		$10,761.59	$16,586.25	$31,745.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,077.38 / $4,366.02 / $5,882.65	Professional		$3,077.38	$4,366.02	$5,882.65
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 $2,553.00 / $3,814.65 / $6,499.73	Professional		$2,553.00	$3,814.65	$6,499.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,865.67 / $1,865.67 / $2,422.16	Professional		$1,865.67	$1,865.67	$2,422.16