Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,858.82 / $9,350.64 / $21,917.86	Facility		$4,858.82	$9,350.64	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,520.87 / $4,858.82 / $10,359.50	Professional		$3,520.87	$4,858.82	$10,359.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,220.31 / $18,633.84 / $35,644.43	Facility		$5,220.31	$18,633.84	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $5,373.38 / $8,671.98 / $33,259.50	Professional		$5,373.38	$8,671.98	$33,259.50
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 $3,799.93 / $6,818.36 / $11,483.57	Professional		$3,799.93	$6,818.36	$11,483.57
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,532.48 / $6,626.71 / $10,450.14	Facility		$3,532.48	$6,626.71	$10,450.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,532.48 / $6,444.91 / $9,606.25	Professional		$3,532.48	$6,444.91	$9,606.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $453.59 / $2,171.43 / $7,345.35	Professional		$453.59	$2,171.43	$7,345.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,609.53 / $6,366.84 / $7,653.41	Facility		$4,609.53	$6,366.84	$7,653.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,140.18 / $5,140.18 / $5,220.31	Facility		$5,140.18	$5,140.18	$5,220.31
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,855.78 / $8,396.78 / $10,361.79	Professional		$5,855.78	$8,396.78	$10,361.79
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 $5,242.31 / $7,430.44 / $9,948.87	Professional		$5,242.31	$7,430.44	$9,948.87
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 $4,362.24 / $6,175.66 / $11,003.80	Professional		$4,362.24	$6,175.66	$11,003.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3,164.56 / $3,164.56 / $4,058.91	Professional		$3,164.56	$3,164.56	$4,058.91