Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,023.64 / $5,128.00 / $23,000.00	Facility		$2,023.64	$5,128.00	$23,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,477.69 / $2,023.64 / $4,379.41	Professional		$1,477.69	$2,023.64	$4,379.41
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,198.63 / $46,149.28 / $90,281.73	Facility		$2,198.63	$46,149.28	$90,281.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,288.19 / $3,682.43 / $14,007.83	Professional		$2,288.19	$3,682.43	$14,007.83
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 $1,692.68 / $2,856.35 / $4,827.87	Professional		$1,692.68	$2,856.35	$4,827.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,537.60 / $3,122.84 / $4,447.63	Facility		$1,537.60	$3,122.84	$4,447.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,537.60 / $3,114.86 / $4,050.83	Professional		$1,537.60	$3,114.86	$4,050.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $213.01 / $899.14 / $3,095.56	Professional		$213.01	$899.14	$3,095.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,068.82 / $2,949.85 / $3,223.37	Facility		$2,068.82	$2,949.85	$3,223.37
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,149.94 / $2,149.94 / $2,198.63	Facility		$2,149.94	$2,149.94	$2,198.63
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,457.51 / $3,512.04 / $4,364.06	Professional		$2,457.51	$3,512.04	$4,364.06
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $36,050.80 / $47,196.58 / $90,281.73	Facility		$36,050.80	$47,196.58	$90,281.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,192.65 / $3,129.46 / $4,166.66	Professional		$2,192.65	$3,129.46	$4,166.66
United Facility/Professional Facility Modifier Low / Median / High Price $3,700.00 / $7,614.00 / $24,236.00	Facility		$3,700.00	$7,614.00	$24,236.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,921.75 / $2,583.44 / $4,617.97	Professional		$1,921.75	$2,583.44	$4,617.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,338.10 / $1,338.10 / $1,708.50	Professional		$1,338.10	$1,338.10	$1,708.50