Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,233.06 / $5,132.00 / $22,024.00	Facility		$2,233.06	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,516.28 / $2,233.06 / $5,027.31	Professional		$1,516.28	$2,233.06	$5,027.31
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,423.46 / $18,220.34 / $35,644.43	Facility		$2,423.46	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,494.53 / $4,011.46 / $15,438.38	Professional		$2,494.53	$4,011.46	$15,438.38
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 $1,781.99 / $3,144.39 / $5,325.37	Professional		$1,781.99	$3,144.39	$5,325.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,586.27 / $2,942.27 / $4,895.08	Facility		$1,586.27	$2,942.27	$4,895.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,586.27 / $2,867.40 / $4,467.57	Professional		$1,586.27	$2,867.40	$4,467.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $213.01 / $984.35 / $3,383.88	Professional		$213.01	$984.35	$3,383.88
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,061.86 / $3,428.96 / $3,553.01	Facility		$2,061.86	$3,428.96	$3,553.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,366.92 / $2,366.92 / $2,423.46	Facility		$2,366.92	$2,366.92	$2,423.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,708.75 / $3,866.50 / $4,810.35	Professional		$2,708.75	$3,866.50	$4,810.35
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 $2,413.94 / $3,449.50 / $4,592.39	Professional		$2,413.94	$3,449.50	$4,592.39
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 $1,603.62 / $2,773.76 / $5,077.72	Professional		$1,603.62	$2,773.76	$5,077.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,475.85 / $1,475.85 / $1,887.65	Professional		$1,475.85	$1,475.85	$1,887.65