Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,278.40 / $5,202.43 / $23,000.00	Facility		$2,278.40	$5,202.43	$23,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,656.01 / $2,278.40 / $5,202.43	Professional		$1,656.01	$2,278.40	$5,202.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,526.30 / $46,149.28 / $90,281.73	Facility		$2,526.30	$46,149.28	$90,281.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,600.37 / $3,982.85 / $18,872.39	Professional		$2,600.37	$3,982.85	$18,872.39
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 $1,889.05 / $3,235.34 / $5,493.55	Professional		$1,889.05	$3,235.34	$5,493.55
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,760.49 / $3,583.93 / $5,092.35	Facility		$1,760.49	$3,583.93	$5,092.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,760.49 / $3,510.80 / $4,588.47	Professional		$1,760.49	$3,510.80	$4,588.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $217.46 / $1,040.51 / $3,499.28	Professional		$217.46	$1,040.51	$3,499.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,617.58 / $3,485.13 / $3,703.76	Facility		$2,617.58	$3,485.13	$3,703.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,453.90 / $2,453.90 / $2,526.30	Facility		$2,453.90	$2,453.90	$2,526.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,811.00 / $4,018.86 / $5,014.45	Professional		$2,811.00	$4,018.86	$5,014.45
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $36,050.80 / $47,196.58 / $90,281.73	Facility		$36,050.80	$47,196.58	$90,281.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,502.65 / $3,595.86 / $4,814.47	Professional		$2,502.65	$3,595.86	$4,814.47
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 $2,208.16 / $3,032.28 / $5,282.26	Professional		$2,208.16	$3,032.28	$5,282.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,523.90 / $1,523.90 / $1,924.09	Professional		$1,523.90	$1,523.90	$1,924.09