Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,211.56 / $9,350.64 / $21,917.86	Facility		$4,211.56	$9,350.64	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,046.37 / $4,211.56 / $9,467.35	Professional		$3,046.37	$4,211.56	$9,467.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,000.00 / $18,633.84 / $35,644.43	Facility		$2,000.00	$18,633.84	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,648.96 / $7,674.73 / $28,776.30	Professional		$4,648.96	$7,674.73	$28,776.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $765.00 / $870.49	Facility		$714.97	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,283.04 / $5,903.34 / $9,951.28	Professional		$3,283.04	$5,903.34	$9,951.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,121.08 / $5,913.84 / $9,027.96	Facility		$3,121.08	$5,913.84	$9,027.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,121.08 / $5,839.44 / $8,291.66	Professional		$3,121.08	$5,839.44	$8,291.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $371.10 / $1,868.85 / $6,335.36	Professional		$371.10	$1,868.85	$6,335.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,366.66 / $6,212.67 / $6,621.61	Facility		$4,366.66	$6,212.67	$6,621.61
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,448.46 / $4,448.46 / $4,516.53	Facility		$4,448.46	$4,448.46	$4,516.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,066.58 / $7,266.80 / $8,964.87	Professional		$5,066.58	$7,266.80	$8,964.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,233.34 / $18,633.84 / $35,644.43	Facility		$14,233.34	$18,633.84	$35,644.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,536.84 / $6,428.70 / $8,607.27	Professional		$4,536.84	$6,428.70	$8,607.27
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $4,016.00 / $16,315.00	Facility		$2,912.00	$4,016.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,807.19 / $5,340.76 / $9,422.82	Professional		$3,807.19	$5,340.76	$9,422.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,736.93 / $2,736.93 / $3,517.01	Professional		$2,736.93	$2,736.93	$3,517.01