Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,728.42 / $10,122.46 / $27,982.24	Facility		$2,728.42	$10,122.46	$27,982.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,929.92 / $2,728.42 / $3,646.50	Professional		$1,929.92	$2,728.42	$3,646.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,873.62 / $38,949.76	Facility		$55.00	$2,873.62	$38,949.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,873.62 / $4,930.21 / $18,350.40	Professional		$2,873.62	$4,930.21	$18,350.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $870.49 / $947.00	Facility		$500.00	$870.49	$947.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,830.05 / $4,231.18 / $6,364.42	Professional		$1,830.05	$4,231.18	$6,364.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,158.33 / $2,262.44 / $4,300.97	Facility		$1,158.33	$2,262.44	$4,300.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,158.33 / $2,335.83 / $4,650.55	Professional		$1,158.33	$2,335.83	$4,650.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $709.55 / $1,013.65	Professional		$80.00	$709.55	$1,013.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $819.30 / $921.50 / $3,613.88	Facility		$819.30	$921.50	$3,613.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,832.61 / $2,832.61 / $2,873.62	Facility		$2,832.61	$2,832.61	$2,873.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,964.26 / $4,762.47 / $5,703.84	Professional		$2,964.26	$4,762.47	$5,703.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,345.36 / $4,133.74 / $5,365.49	Professional		$3,345.36	$4,133.74	$5,365.49
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $1,120.00 / $5,793.00	Facility		$650.00	$1,120.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,365.23 / $3,578.20 / $6,463.46	Professional		$2,365.23	$3,578.20	$6,463.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $977.57 / $977.57 / $2,032.26	Professional		$977.57	$977.57	$2,032.26