Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,167.82 / $7,150.33 / $22,024.00	Facility		$3,167.82	$7,150.33	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,162.54 / $3,167.82 / $7,150.33	Professional		$2,162.54	$3,167.82	$7,150.33
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,441.21 / $18,633.84 / $35,644.43	Facility		$3,441.21	$18,633.84	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,492.67 / $5,702.95 / $21,922.43	Professional		$3,492.67	$5,702.95	$21,922.43
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 $2,545.64 / $4,471.45 / $7,548.68	Professional		$2,545.64	$4,471.45	$7,548.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,266.10 / $4,203.25 / $6,978.11	Facility		$2,266.10	$4,203.25	$6,978.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,266.10 / $4,079.26 / $6,341.21	Professional		$2,266.10	$4,079.26	$6,341.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $292.86 / $1,426.02 / $4,845.66	Professional		$292.86	$1,426.02	$4,845.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,946.66 / $4,858.52 / $5,045.10	Facility		$2,946.66	$4,858.52	$5,045.10
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,370.77 / $3,370.77 / $3,441.21	Facility		$3,370.77	$3,370.77	$3,441.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,850.93 / $5,506.34 / $6,830.46	Professional		$3,850.93	$5,506.34	$6,830.46
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 $3,437.74 / $4,898.10 / $6,540.68	Professional		$3,437.74	$4,898.10	$6,540.68
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 $2,448.48 / $4,122.25 / $7,236.44	Professional		$2,448.48	$4,122.25	$7,236.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,093.42 / $2,093.42 / $2,664.78	Professional		$2,093.42	$2,093.42	$2,664.78