Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,075.96 / $5,128.00 / $23,000.00	Facility		$2,075.96	$5,128.00	$23,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,515.64 / $2,075.96 / $4,620.01	Professional		$1,515.64	$2,075.96	$4,620.01
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,254.38 / $46,149.28 / $90,281.73	Facility		$2,254.38	$46,149.28	$90,281.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,320.48 / $3,804.63 / $14,361.38	Professional		$2,320.48	$3,804.63	$14,361.38
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 $1,728.59 / $2,931.34 / $4,954.95	Professional		$1,728.59	$2,931.34	$4,954.95
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,575.70 / $3,250.91 / $4,545.37	Facility		$1,575.70	$3,250.91	$4,545.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,571.39 / $3,184.58 / $4,157.16	Professional		$1,571.39	$3,184.58	$4,157.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $216.17 / $903.16 / $3,149.55	Professional		$216.17	$903.16	$3,149.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,267.94 / $3,136.27 / $3,305.11	Facility		$2,267.94	$3,136.27	$3,305.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,201.58 / $2,201.58 / $2,254.38	Facility		$2,201.58	$2,201.58	$2,254.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,520.19 / $3,596.40 / $4,474.72	Professional		$2,520.19	$3,596.40	$4,474.72
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 $2,245.32 / $3,208.82 / $4,271.97	Professional		$2,245.32	$3,208.82	$4,271.97
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 $2,045.16 / $2,764.86 / $4,711.00	Professional		$2,045.16	$2,764.86	$4,711.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,372.33 / $1,372.33 / $1,756.57	Professional		$1,372.33	$1,372.33	$1,756.57