Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,197.86 / $5,128.00 / $21,917.86	Facility		$2,197.86	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,607.77 / $2,197.86 / $4,950.46	Professional		$1,607.77	$2,197.86	$4,950.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,370.00 / $15,127.44 / $28,937.08	Facility		$2,370.00	$15,127.44	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,477.35 / $4,038.14 / $15,026.78	Professional		$2,477.35	$4,038.14	$15,026.78
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 $1,844.31 / $3,104.46 / $5,224.35	Professional		$1,844.31	$3,104.46	$5,224.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,658.00 / $3,412.14 / $4,791.06	Facility		$1,658.00	$3,412.14	$4,791.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,656.33 / $3,359.81 / $4,402.39	Professional		$1,656.33	$3,359.81	$4,402.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $189.74 / $987.98 / $3,378.32	Professional		$189.74	$987.98	$3,378.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,428.80 / $3,358.71 / $3,474.62	Facility		$2,428.80	$3,358.71	$3,474.62
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,324.34 / $2,324.34 / $2,370.00	Facility		$2,324.34	$2,324.34	$2,370.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,660.46 / $3,796.94 / $4,704.22	Professional		$2,660.46	$3,796.94	$4,704.22
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 $2,370.52 / $3,373.39 / $4,491.08	Professional		$2,370.52	$3,373.39	$4,491.08
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 $2,121.42 / $2,778.05 / $4,999.35	Professional		$2,121.42	$2,778.05	$4,999.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,444.66 / $1,444.66 / $1,857.35	Professional		$1,444.66	$1,444.66	$1,857.35