Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,624.24 / $5,906.01 / $22,024.00	Facility		$2,624.24	$5,906.01	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,916.69 / $2,624.24 / $5,906.01	Professional		$1,916.69	$2,624.24	$5,906.01
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,850.77 / $18,633.84 / $35,644.43	Facility		$2,850.77	$18,633.84	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,979.89 / $4,821.16 / $18,160.95	Professional		$2,979.89	$4,821.16	$18,160.95
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 $2,196.76 / $3,707.93 / $6,258.43	Professional		$2,196.76	$3,707.93	$6,258.43
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,177.66 / $4,123.72 / $5,770.26	Facility		$2,177.66	$4,123.72	$5,770.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,007.25 / $4,039.59 / $5,253.04	Professional		$2,007.25	$4,039.59	$5,253.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $217.63 / $1,175.14 / $4,051.83	Professional		$217.63	$1,175.14	$4,051.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,919.11 / $4,028.94 / $4,179.46	Facility		$2,919.11	$4,028.94	$4,179.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,789.12 / $2,789.12 / $2,850.77	Facility		$2,789.12	$2,789.12	$2,850.77
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,187.62 / $4,556.18 / $5,658.49	Professional		$3,187.62	$4,556.18	$5,658.49
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 $2,844.53 / $4,057.70 / $5,406.96	Professional		$2,844.53	$4,057.70	$5,406.96
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 $2,543.11 / $3,451.35 / $5,989.96	Professional		$2,543.11	$3,451.35	$5,989.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,735.09 / $1,735.09 / $2,213.54	Professional		$1,735.09	$1,735.09	$2,213.54