Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,117.96 / $7,589.38 / $23,000.00	Facility		$3,117.96	$7,589.38	$23,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,406.19 / $3,117.96 / $7,589.38	Professional		$2,406.19	$3,117.96	$7,589.38
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,388.20 / $46,149.28 / $90,281.73	Facility		$3,388.20	$46,149.28	$90,281.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,729.55 / $5,681.00 / $21,584.93	Professional		$3,729.55	$5,681.00	$21,584.93
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 $2,665.35 / $4,611.45 / $7,434.09	Professional		$2,665.35	$4,611.45	$7,434.09
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,521.34 / $5,051.75 / $6,862.44	Facility		$2,521.34	$5,051.75	$6,862.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,469.15 / $4,832.58 / $6,512.66	Professional		$2,469.15	$4,832.58	$6,512.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $273.26 / $1,021.82 / $5,127.59	Professional		$273.26	$1,021.82	$5,127.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,847.90 / $4,785.02 / $5,321.14	Facility		$3,847.90	$4,785.02	$5,321.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,317.32 / $3,317.32 / $3,388.20	Facility		$3,317.32	$3,317.32	$3,388.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,790.82 / $5,419.02 / $6,725.24	Professional		$3,790.82	$5,419.02	$6,725.24
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 $3,383.23 / $4,822.66 / $6,434.09	Professional		$3,383.23	$4,822.66	$6,434.09
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 $3,034.13 / $4,148.87 / $7,123.47	Professional		$3,034.13	$4,148.87	$7,123.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,061.39 / $2,061.39 / $2,625.77	Professional		$2,061.39	$2,061.39	$2,625.77