Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,584.21 / $5,407.14 / $21,917.86	Facility		$2,584.21	$5,407.14	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,888.30 / $2,584.21 / $5,563.04	Professional		$1,888.30	$2,584.21	$5,563.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,787.24 / $15,127.44 / $28,937.08	Facility		$2,787.24	$15,127.44	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,868.97 / $4,742.00 / $17,676.38	Professional		$2,868.97	$4,742.00	$17,676.38
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 $2,092.73 / $3,648.94 / $6,154.89	Professional		$2,092.73	$3,648.94	$6,154.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,946.80 / $3,646.06 / $5,631.27	Facility		$1,946.80	$3,646.06	$5,631.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,946.80 / $3,642.40 / $5,165.01	Professional		$1,946.80	$3,642.40	$5,165.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $255.08 / $1,108.32 / $3,970.69	Professional		$255.08	$1,108.32	$3,970.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,799.82 / $3,848.13 / $4,086.33	Facility		$2,799.82	$3,848.13	$4,086.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,726.61 / $2,726.61 / $2,787.24	Facility		$2,726.61	$2,726.61	$2,787.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,124.93 / $4,454.06 / $5,532.40	Professional		$3,124.93	$4,454.06	$5,532.40
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 $2,780.78 / $3,967.28 / $5,281.73	Professional		$2,780.78	$3,967.28	$5,281.73
United Facility/Professional Facility Modifier Low / Median / High Price $2,225.00 / $4,135.00 / $16,315.00	Facility		$2,225.00	$4,135.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,351.42 / $3,138.67 / $5,872.18	Professional		$2,351.42	$3,138.67	$5,872.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,698.64 / $1,698.64 / $2,188.66	Professional		$1,698.64	$1,698.64	$2,188.66