Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,098.88 / $6,470.00 / $24,827.00	Facility		$2,098.88	$6,470.00	$24,827.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,496.90 / $2,098.88 / $4,568.49	Professional		$1,496.90	$2,098.88	$4,568.49
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $9,543.20 / $16,595.73 / $31,745.76	Facility		$9,543.20	$16,595.73	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,198.66 / $3,521.66 / $23,959.18	Professional		$2,198.66	$3,521.66	$23,959.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,394.89 / $1,698.13 / $11,615.26	Facility		$1,394.89	$1,698.13	$11,615.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,652.57 / $2,890.89 / $4,873.59	Professional		$1,652.57	$2,890.89	$4,873.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,661.26 / $3,439.40 / $10,186.20	Facility		$1,661.26	$3,439.40	$10,186.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,589.12 / $3,408.10 / $8,771.23	Professional		$1,589.12	$3,408.10	$8,771.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $911.36 / $3,149.27	Professional		$157.37	$911.36	$3,149.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,209.32 / $3,081.59 / $3,211.31	Facility		$2,209.32	$3,081.59	$3,211.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,155.83 / $2,190.40 / $8,276.32	Facility		$2,155.83	$2,190.40	$8,276.32
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,464.17 / $3,484.51 / $4,347.72	Professional		$2,464.17	$3,484.51	$4,347.72
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 $2,198.66 / $3,117.75 / $4,213.34	Professional		$2,198.66	$3,117.75	$4,213.34
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 $1,957.27 / $2,535.80 / $4,630.54	Professional		$1,957.27	$2,535.80	$4,630.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,332.03 / $1,332.03 / $1,740.75	Professional		$1,332.03	$1,332.03	$1,740.75