Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,433.92 / $6,470.00 / $23,000.00	Facility		$2,433.92	$6,470.00	$23,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,514.89 / $2,232.96 / $4,588.95	Professional		$1,514.89	$2,232.96	$4,588.95
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $44,362.53 / $90,281.73	Facility		$5,000.00	$44,362.53	$90,281.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,465.84 / $3,938.93 / $15,261.60	Professional		$2,465.84	$3,938.93	$15,261.60
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 $1,780.06 / $3,151.18 / $5,262.04	Professional		$1,780.06	$3,151.18	$5,262.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,600.53 / $2,994.54 / $4,629.66	Facility		$1,600.53	$2,994.54	$4,629.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,600.53 / $2,885.51 / $4,281.87	Professional		$1,600.53	$2,885.51	$4,281.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $217.46 / $1,007.46 / $3,331.94	Professional		$217.46	$1,007.46	$3,331.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,491.78 / $3,388.39 / $3,512.14	Facility		$2,491.78	$3,388.39	$3,512.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,367.83 / $2,367.83 / $2,395.59	Facility		$2,367.83	$2,367.83	$2,395.59
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,709.27 / $3,867.98 / $4,755.02	Professional		$2,709.27	$3,867.98	$4,755.02
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 $2,414.87 / $3,413.74 / $4,588.60	Professional		$2,414.87	$3,413.74	$4,588.60
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 $2,052.00 / $2,859.50 / $5,091.08	Professional		$2,052.00	$2,859.50	$5,091.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,458.74 / $1,458.74 / $1,863.88	Professional		$1,458.74	$1,458.74	$1,863.88