Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,592.31 / $5,768.22 / $23,000.00	Facility		$2,592.31	$5,768.22	$23,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,839.53 / $2,592.31 / $5,768.22	Professional		$1,839.53	$2,592.31	$5,768.22
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,752.51 / $46,149.28 / $90,281.73	Facility		$2,752.51	$46,149.28	$90,281.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,833.22 / $4,398.56 / $18,269.46	Professional		$2,833.22	$4,398.56	$18,269.46
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 $2,118.27 / $3,576.09 / $6,043.41	Professional		$2,118.27	$3,576.09	$6,043.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,921.85 / $3,963.89 / $5,423.24	Facility		$1,921.85	$3,963.89	$5,423.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,897.38 / $3,821.81 / $5,004.72	Professional		$1,897.38	$3,821.81	$5,004.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $217.63 / $1,154.93 / $3,903.00	Professional		$217.63	$1,154.93	$3,903.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,885.20 / $3,890.19 / $4,041.92	Facility		$2,885.20	$3,890.19	$4,041.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,692.63 / $2,692.63 / $2,752.51	Facility		$2,692.63	$2,692.63	$2,752.51
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,077.15 / $4,379.03 / $5,463.46	Professional		$3,077.15	$4,379.03	$5,463.46
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 $2,746.13 / $3,917.84 / $5,333.37	Professional		$2,746.13	$3,917.84	$5,333.37
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 $2,499.00 / $3,254.83 / $5,782.37	Professional		$2,499.00	$3,254.83	$5,782.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,675.18 / $1,675.18 / $2,137.80	Professional		$1,675.18	$1,675.18	$2,137.80