Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,152.44 / $6,470.00 / $25,612.66	Facility		$2,152.44	$6,470.00	$25,612.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,563.39 / $2,152.44 / $4,525.47	Professional		$1,563.39	$2,152.44	$4,525.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,338.01 / $18,220.34 / $35,644.43	Facility		$2,338.01	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,406.57 / $3,944.58 / $16,935.64	Professional		$2,406.57	$3,944.58	$16,935.64
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 $1,793.58 / $3,039.12 / $5,137.70	Professional		$1,793.58	$3,039.12	$5,137.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,645.00 / $3,371.77 / $4,716.64	Facility		$1,645.00	$3,371.77	$4,716.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,630.60 / $3,302.96 / $4,309.79	Professional		$1,630.60	$3,302.96	$4,309.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $217.46 / $984.35 / $3,315.43	Professional		$217.46	$984.35	$3,315.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,440.42 / $3,274.29 / $3,427.72	Facility		$2,440.42	$3,274.29	$3,427.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,284.03 / $2,284.03 / $2,338.01	Facility		$2,284.03	$2,284.03	$2,338.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,613.19 / $3,731.08 / $4,640.72	Professional		$2,613.19	$3,731.08	$4,640.72
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 $2,329.40 / $3,327.85 / $4,430.46	Professional		$2,329.40	$3,327.85	$4,430.46
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 $2,077.73 / $2,797.29 / $4,910.53	Professional		$2,077.73	$2,797.29	$4,910.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,423.68 / $1,423.68 / $1,821.05	Professional		$1,423.68	$1,423.68	$1,821.05