Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,708.72 / $6,209.36 / $23,000.00	Facility		$2,708.72	$6,209.36	$23,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,987.43 / $2,708.72 / $6,209.36	Professional		$1,987.43	$2,708.72	$6,209.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,943.54 / $46,149.28 / $90,281.73	Facility		$2,943.54	$46,149.28	$90,281.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,076.87 / $4,677.66 / $31,286.77	Professional		$3,076.87	$4,677.66	$31,286.77
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 $2,274.00 / $3,836.61 / $6,457.39	Professional		$2,274.00	$3,836.61	$6,457.39
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,093.98 / $4,325.83 / $5,969.33	Facility		$2,093.98	$4,325.83	$5,969.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,082.50 / $4,203.79 / $5,497.16	Professional		$2,082.50	$4,203.79	$5,497.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $349.48 / $2,161.39 / $4,694.07	Professional		$349.48	$2,161.39	$4,694.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,080.94 / $4,156.97 / $4,315.47	Facility		$3,080.94	$4,156.97	$4,315.47
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,881.99 / $2,881.99 / $2,943.54	Facility		$2,881.99	$2,881.99	$2,943.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,291.40 / $4,707.88 / $5,842.63	Professional		$3,291.40	$4,707.88	$5,842.63
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 $2,939.24 / $4,189.74 / $5,591.95	Professional		$2,939.24	$4,189.74	$5,591.95
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 $2,690.52 / $3,436.75 / $6,184.99	Professional		$2,690.52	$3,436.75	$6,184.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,791.13 / $1,791.13 / $2,280.46	Professional		$1,791.13	$1,791.13	$2,280.46