Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,790.12 / $5,726.44 / $23,000.00	Facility		$2,790.12	$5,726.44	$23,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,011.63 / $2,790.12 / $6,122.91	Professional		$2,011.63	$2,790.12	$6,122.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $34,428.37 / $70,064.83	Facility		$5,000.00	$34,428.37	$70,064.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,178.59 / $5,095.29 / $20,858.84	Professional		$3,178.59	$5,095.29	$20,858.84
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 $2,203.76 / $3,992.24 / $6,784.66	Professional		$2,203.76	$3,992.24	$6,784.66
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,984.43 / $4,083.86 / $5,662.07	Facility		$1,984.43	$4,083.86	$5,662.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,963.84 / $3,937.48 / $5,329.94	Professional		$1,963.84	$3,937.48	$5,329.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $217.63 / $1,228.28 / $4,408.11	Professional		$217.63	$1,228.28	$4,408.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,907.17 / $4,013.57 / $4,612.95	Facility		$2,907.17	$4,013.57	$4,612.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,040.54 / $3,040.54 / $3,146.45	Facility		$3,040.54	$3,040.54	$3,146.45
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,503.95 / $5,005.39 / $6,245.38	Professional		$3,503.95	$5,005.39	$6,245.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $27,977.90 / $36,627.79 / $70,064.83	Facility		$27,977.90	$36,627.79	$70,064.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,100.94 / $4,478.55 / $5,962.41	Professional		$3,100.94	$4,478.55	$5,962.41
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $5,547.00 / $19,271.00	Facility		$3,028.00	$5,547.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,601.90 / $3,650.07 / $6,585.69	Professional		$2,601.90	$3,650.07	$6,585.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,910.11 / $1,910.11 / $2,393.61	Professional		$1,910.11	$1,910.11	$2,393.61