Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,588.98 / $5,834.65 / $22,024.00	Facility		$2,588.98	$5,834.65	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,727.63 / $2,588.98 / $5,834.65	Professional		$1,727.63	$2,588.98	$5,834.65
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,811.46 / $35,815.01 / $70,064.83	Facility		$2,811.46	$35,815.01	$70,064.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,893.90 / $4,654.43 / $17,910.98	Professional		$2,893.90	$4,654.43	$17,910.98
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 $2,073.29 / $3,652.39 / $6,172.47	Professional		$2,073.29	$3,652.39	$6,172.47
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,845.43 / $3,422.97 / $5,689.56	Facility		$1,845.43	$3,422.97	$5,689.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,845.43 / $3,333.50 / $5,180.14	Professional		$1,845.43	$3,333.50	$5,180.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $217.63 / $1,169.61 / $3,940.10	Professional		$217.63	$1,169.61	$3,940.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,399.14 / $3,973.72 / $4,121.84	Facility		$2,399.14	$3,973.72	$4,121.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,750.16 / $2,750.16 / $2,811.46	Facility		$2,750.16	$2,750.16	$2,811.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,142.91 / $4,492.54 / $5,580.48	Professional		$3,142.91	$4,492.54	$5,580.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $27,977.90 / $36,627.79 / $70,064.83	Facility		$27,977.90	$36,627.79	$70,064.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,804.80 / $4,001.75 / $5,333.85	Professional		$2,804.80	$4,001.75	$5,333.85
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 $1,830.76 / $3,222.73 / $5,905.97	Professional		$1,830.76	$3,222.73	$5,905.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,711.34 / $1,711.34 / $2,183.53	Professional		$1,711.34	$1,711.34	$2,183.53