Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,430.29 / $5,436.36 / $23,000.00	Facility		$2,430.29	$5,436.36	$23,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,751.26 / $2,430.29 / $5,436.36	Professional		$1,751.26	$2,430.29	$5,436.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,738.80 / $44,362.53 / $90,281.73	Facility		$2,738.80	$44,362.53	$90,281.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,820.16 / $4,541.53 / $18,143.18	Professional		$2,820.16	$4,541.53	$18,143.18
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 $2,073.61 / $3,476.34 / $5,912.99	Professional		$2,073.61	$3,476.34	$5,912.99
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,862.47 / $3,758.27 / $5,395.44	Facility		$1,862.47	$3,758.27	$5,395.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,862.47 / $3,650.51 / $4,929.76	Professional		$1,862.47	$3,650.51	$4,929.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $217.46 / $1,131.59 / $3,783.24	Professional		$217.46	$1,131.59	$3,783.24
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,756.32 / $3,748.95 / $4,015.31	Facility		$2,756.32	$3,748.95	$4,015.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,642.80 / $2,642.80 / $2,738.80	Facility		$2,642.80	$2,642.80	$2,738.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,047.86 / $4,356.91 / $5,436.25	Professional		$3,047.86	$4,356.91	$5,436.25
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $34,438.60 / $47,169.60 / $90,281.73	Facility		$34,438.60	$47,169.60	$90,281.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,695.31 / $3,898.33 / $5,220.16	Professional		$2,695.31	$3,898.33	$5,220.16
United Facility/Professional Facility Modifier Low / Median / High Price $3,700.00 / $7,614.00 / $24,236.00	Facility		$3,700.00	$7,614.00	$24,236.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,372.58 / $3,118.10 / $5,635.41	Professional		$2,372.58	$3,118.10	$5,635.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,663.03 / $1,663.03 / $2,090.06	Professional		$1,663.03	$1,663.03	$2,090.06