Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,265.79 / $5,128.00 / $23,000.00	Facility		$2,265.79	$5,128.00	$23,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,703.55 / $2,265.79 / $5,089.55	Professional		$1,703.55	$2,265.79	$5,089.55
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,554.63 / $35,815.01 / $70,064.83	Facility		$2,554.63	$35,815.01	$70,064.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,626.97 / $4,061.44 / $18,574.00	Professional		$2,626.97	$4,061.44	$18,574.00
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 $1,948.36 / $3,242.30 / $5,513.92	Professional		$1,948.36	$3,242.30	$5,513.92
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,736.00 / $3,497.64 / $5,021.52	Facility		$1,736.00	$3,497.64	$5,021.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,736.00 / $3,456.23 / $4,597.91	Professional		$1,736.00	$3,456.23	$4,597.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $217.32 / $983.42 / $3,493.74	Professional		$217.32	$983.42	$3,493.74
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,606.80 / $3,494.34 / $3,745.30	Facility		$2,606.80	$3,494.34	$3,745.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,466.59 / $2,466.59 / $2,554.63	Facility		$2,466.59	$2,466.59	$2,554.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,843.37 / $4,063.93 / $5,070.68	Professional		$2,843.37	$4,063.93	$5,070.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $27,977.90 / $36,627.79 / $70,064.83	Facility		$27,977.90	$36,627.79	$70,064.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,515.59 / $3,636.18 / $4,840.93	Professional		$2,515.59	$3,636.18	$4,840.93
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 $2,211.30 / $3,043.70 / $5,343.09	Professional		$2,211.30	$3,043.70	$5,343.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,550.40 / $1,550.40 / $1,947.51	Professional		$1,550.40	$1,550.40	$1,947.51