Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,186.11 / $5,132.00 / $22,024.00	Facility		$2,186.11	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,494.68 / $2,186.11 / $4,721.34	Professional		$1,494.68	$2,186.11	$4,721.34
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,458.66 / $18,633.84 / $35,644.43	Facility		$2,458.66	$18,633.84	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,478.65 / $4,095.10 / $16,257.00	Professional		$2,478.65	$4,095.10	$16,257.00
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 $1,747.90 / $3,125.86 / $5,324.00	Professional		$1,747.90	$3,125.86	$5,324.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,555.58 / $2,945.25 / $4,801.82	Facility		$1,555.58	$2,945.25	$4,801.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,555.58 / $2,885.35 / $4,418.34	Professional		$1,555.58	$2,885.35	$4,418.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $179.84 / $1,049.13 / $3,418.92	Professional		$179.84	$1,049.13	$3,418.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,142.77 / $2,994.90 / $3,604.60	Facility		$2,142.77	$2,994.90	$3,604.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,366.92 / $2,366.92 / $2,458.66	Facility		$2,366.92	$2,366.92	$2,458.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,732.37 / $3,911.26 / $4,880.20	Professional		$2,732.37	$3,911.26	$4,880.20
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,154.00 / $18,623.18 / $35,644.43	Facility		$12,154.00	$18,623.18	$35,644.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,413.94 / $3,499.58 / $4,659.08	Professional		$2,413.94	$3,499.58	$4,659.08
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $5,547.00 / $19,271.00	Facility		$3,028.00	$5,547.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,960.13 / $2,834.38 / $5,053.05	Professional		$1,960.13	$2,834.38	$5,053.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,493.53 / $1,493.53 / $1,890.08	Professional		$1,493.53	$1,493.53	$1,890.08