Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,154.36 / $4,628.31 / $22,024.00	Facility		$2,154.36	$4,628.31	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,496.84 / $2,154.36 / $4,628.31	Professional		$1,496.84	$2,154.36	$4,628.31
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,490.98 / $9,172.83 / $17,546.59	Facility		$5,490.98	$9,172.83	$17,546.59
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,343.06 / $3,859.45 / $14,499.83	Professional		$2,343.06	$3,859.45	$14,499.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $3,740.43	Facility		$625.25	$761.81	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,704.19 / $2,994.81 / $5,074.16	Professional		$1,704.19	$2,994.81	$5,074.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,592.10 / $2,918.56 / $4,247.18	Facility		$1,592.10	$2,918.56	$4,247.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,559.92 / $2,926.17 / $4,151.56	Professional		$1,559.92	$2,926.17	$4,151.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.79 / $979.76 / $3,216.51	Professional		$157.79	$979.76	$3,216.51
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,257.77 / $3,122.20 / $3,337.27	Facility		$2,257.77	$3,122.20	$3,337.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $986.25 / $2,250.96 / $2,961.46	Facility		$986.25	$2,250.96	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,559.23 / $3,677.06 / $4,518.27	Professional		$2,559.23	$3,677.06	$4,518.27
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,013.44 / $9,167.59 / $17,546.59	Facility		$6,013.44	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,295.67 / $3,240.04 / $4,347.24	Professional		$2,295.67	$3,240.04	$4,347.24
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,129.00 / $11,941.00	Facility		$2,155.00	$3,129.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,885.49 / $2,608.64 / $4,731.95	Professional		$1,885.49	$2,608.64	$4,731.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,374.82 / $1,374.82 / $1,788.77	Professional		$1,374.82	$1,374.82	$1,788.77