Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,138.32 / $5,336.90 / $20,680.40	Facility		$3,138.32	$5,336.90	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,058.92 / $2,965.18 / $5,962.81	Professional		$2,058.92	$2,965.18	$5,962.81
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $3,140.50 / $21,117.92	Facility		$55.00	$3,140.50	$21,117.92
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,232.59 / $5,531.96 / $20,241.30	Professional		$3,232.59	$5,531.96	$20,241.30
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 $2,144.89 / $4,057.18 / $6,837.37	Professional		$2,144.89	$4,057.18	$6,837.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,185.81 / $4,385.25 / $5,753.82	Facility		$2,185.81	$4,385.25	$5,753.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,185.81 / $4,385.25 / $5,850.92	Professional		$2,185.81	$4,385.25	$5,850.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $203.03 / $800.32 / $5,083.28	Professional		$203.03	$800.32	$5,083.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,261.93 / $4,369.51 / $4,604.24	Facility		$3,261.93	$4,369.51	$4,604.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,113.02 / $3,113.02 / $3,140.50	Facility		$3,113.02	$3,113.02	$3,140.50
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,298.56 / $5,214.45 / $6,293.80	Professional		$3,298.56	$5,214.45	$6,293.80
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,676.52 / $4,517.64 / $5,903.05	Professional		$3,676.52	$4,517.64	$5,903.05
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 $2,432.44 / $3,909.20 / $6,616.58	Professional		$2,432.44	$3,909.20	$6,616.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,902.93 / $2,392.67 / $2,392.67	Professional		$1,902.93	$2,392.67	$2,392.67