Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,000.21 / $6,470.00 / $25,612.66	Facility		$2,000.21	$6,470.00	$25,612.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,419.50 / $2,000.21 / $4,309.89	Professional		$1,419.50	$2,000.21	$4,309.89
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,171.21 / $18,220.34 / $35,644.43	Facility		$2,171.21	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,262.31 / $3,593.73 / $15,183.90	Professional		$2,262.31	$3,593.73	$15,183.90
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 $1,604.31 / $2,823.22 / $4,773.45	Professional		$1,604.31	$2,823.22	$4,773.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,513.42 / $3,073.27 / $4,377.68	Facility		$1,513.42	$3,073.27	$4,377.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,513.42 / $3,066.19 / $4,003.66	Professional		$1,513.42	$3,066.19	$4,003.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $903.03 / $3,076.91	Professional		$157.37	$903.03	$3,076.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,226.28 / $3,073.04 / $3,183.17	Facility		$2,226.28	$3,073.04	$3,183.17
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,120.04 / $2,120.04 / $2,171.21	Facility		$2,120.04	$2,120.04	$2,171.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,426.67 / $3,463.20 / $4,309.63	Professional		$2,426.67	$3,463.20	$4,309.63
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 $2,162.16 / $3,090.43 / $4,114.37	Professional		$2,162.16	$3,090.43	$4,114.37
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 $1,840.80 / $2,567.44 / $4,534.10	Professional		$1,840.80	$2,567.44	$4,534.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,322.08 / $1,322.08 / $1,693.25	Professional		$1,322.08	$1,322.08	$1,693.25