Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,777.12 / $6,250.17 / $23,000.00	Facility		$2,777.12	$6,250.17	$23,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,013.71 / $2,777.12 / $6,250.17	Professional		$2,013.71	$2,777.12	$6,250.17
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,016.66 / $46,149.28 / $90,281.73	Facility		$3,016.66	$46,149.28	$90,281.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,147.90 / $4,787.95 / $21,191.92	Professional		$3,147.90	$4,787.95	$21,191.92
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 $2,351.85 / $3,920.09 / $6,625.58	Professional		$2,351.85	$3,920.09	$6,625.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,157.87 / $4,351.34 / $6,085.90	Facility		$2,157.87	$4,351.34	$6,085.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,103.96 / $4,262.55 / $5,559.17	Professional		$2,103.96	$4,262.55	$5,559.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $255.53 / $1,185.84 / $4,260.61	Professional		$255.53	$1,185.84	$4,260.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,184.51 / $4,262.54 / $4,422.67	Facility		$3,184.51	$4,262.54	$4,422.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,949.94 / $2,949.94 / $3,016.66	Facility		$2,949.94	$2,949.94	$3,016.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,372.07 / $4,818.88 / $5,987.77	Professional		$3,372.07	$4,818.88	$5,987.77
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 $3,008.54 / $4,293.82 / $5,716.47	Professional		$3,008.54	$4,293.82	$5,716.47
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 $2,684.22 / $3,515.04 / $6,327.09	Professional		$2,684.22	$3,515.04	$6,327.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,835.85 / $1,835.85 / $2,345.08	Professional		$1,835.85	$1,835.85	$2,345.08