Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,615.07 / $5,128.00 / $21,917.86	Facility		$2,615.07	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,865.67 / $2,615.07 / $5,526.39	Professional		$1,865.67	$2,615.07	$5,526.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,748.40 / $15,127.44 / $28,937.08	Facility		$2,748.40	$15,127.44	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,756.75 / $4,405.26 / $29,283.99	Professional		$2,756.75	$4,405.26	$29,283.99
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 $2,065.42 / $3,619.22 / $6,132.71	Professional		$2,065.42	$3,619.22	$6,132.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,889.88 / $3,706.78 / $5,730.80	Facility		$1,889.88	$3,706.78	$5,730.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,889.88 / $3,657.15 / $5,132.99	Professional		$1,889.88	$3,657.15	$5,132.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $235.62 / $1,172.13 / $3,949.32	Professional		$235.62	$1,172.13	$3,949.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,459.80 / $3,480.67 / $4,029.38	Facility		$2,459.80	$3,480.67	$4,029.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,703.05 / $2,703.05 / $2,748.40	Facility		$2,703.05	$2,703.05	$2,748.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,088.97 / $4,415.58 / $5,455.30	Professional		$3,088.97	$4,415.58	$5,455.30
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 $2,756.75 / $3,911.99 / $5,271.31	Professional		$2,756.75	$3,911.99	$5,271.31
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 $2,262.16 / $3,176.83 / $5,804.59	Professional		$2,262.16	$3,176.83	$5,804.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,671.86 / $1,671.86 / $2,176.00	Professional		$1,671.86	$1,671.86	$2,176.00