Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,056.65 / $4,500.00 / $22,024.00	Facility		$2,056.65	$4,500.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,499.24 / $2,056.65 / $4,552.02	Professional		$1,499.24	$2,056.65	$4,552.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,231.07 / $46,149.28 / $90,281.73	Facility		$2,231.07	$46,149.28	$90,281.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,261.50 / $3,560.88 / $14,468.63	Professional		$2,261.50	$3,560.88	$14,468.63
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 $1,698.69 / $2,902.10 / $4,906.72	Professional		$1,698.69	$2,902.10	$4,906.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,544.73 / $3,147.63 / $4,468.25	Facility		$1,544.73	$3,147.63	$4,468.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,544.73 / $3,130.65 / $4,109.29	Professional		$1,544.73	$3,130.65	$4,109.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $176.57 / $906.29 / $3,148.28	Professional		$176.57	$906.29	$3,148.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,276.05 / $3,108.80 / $3,270.94	Facility		$2,276.05	$3,108.80	$3,270.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,179.84 / $2,179.84 / $2,231.07	Facility		$2,179.84	$2,179.84	$2,231.07
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,493.46 / $3,560.88 / $4,428.46	Professional		$2,493.46	$3,560.88	$4,428.46
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 $2,223.14 / $3,175.64 / $4,227.81	Professional		$2,223.14	$3,175.64	$4,227.81
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 $1,976.01 / $2,698.37 / $4,685.59	Professional		$1,976.01	$2,698.37	$4,685.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,357.97 / $1,357.97 / $1,740.90	Professional		$1,357.97	$1,357.97	$1,740.90