Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,350.71 / $9,350.64 / $21,917.86	Facility		$4,350.71	$9,350.64	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,877.75 / $4,350.71 / $9,594.95	Professional		$2,877.75	$4,350.71	$9,594.95
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,667.80 / $18,633.84 / $35,644.43	Facility		$4,667.80	$18,633.84	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,804.67 / $7,922.93 / $29,739.68	Professional		$4,804.67	$7,922.93	$29,739.68
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 $3,384.76 / $6,100.09 / $10,292.91	Professional		$3,384.76	$6,100.09	$10,292.91
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,135.04 / $5,932.08 / $9,319.40	Facility		$3,135.04	$5,932.08	$9,319.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,135.04 / $5,761.99 / $8,556.69	Professional		$3,135.04	$5,761.99	$8,556.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $371.10 / $1,873.17 / $6,587.91	Professional		$371.10	$1,873.17	$6,587.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,674.60 / $6,235.64 / $6,843.38	Facility		$4,674.60	$6,235.64	$6,843.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,593.87 / $4,593.87 / $4,667.80	Facility		$4,593.87	$4,593.87	$4,667.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,234.08 / $7,504.34 / $9,265.12	Professional		$5,234.08	$7,504.34	$9,265.12
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 $4,685.14 / $6,644.00 / $8,885.64	Professional		$4,685.14	$6,644.00	$8,885.64
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 $3,838.27 / $5,697.33 / $9,724.76	Professional		$3,838.27	$5,697.33	$9,724.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,828.87 / $2,828.87 / $3,638.06	Professional		$2,828.87	$2,828.87	$3,638.06