Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,165.14 / $4,063.87 / $20,680.40	Facility		$2,165.14	$4,063.87	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,413.98 / $2,069.16 / $4,063.87	Professional		$1,413.98	$2,069.16	$4,063.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,194.06 / $14,751.52	Facility		$55.00	$2,194.06	$14,751.52
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,307.30 / $3,846.29 / $14,140.65	Professional		$2,307.30	$3,846.29	$14,140.65
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 $1,589.84 / $2,825.24 / $4,774.80	Professional		$1,589.84	$2,825.24	$4,774.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,499.16 / $3,038.10 / $4,008.81	Facility		$1,499.16	$3,038.10	$4,008.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,499.16 / $3,038.10 / $4,019.48	Professional		$1,499.16	$3,038.10	$4,019.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $148.46 / $600.48 / $3,531.00	Professional		$148.46	$600.48	$3,531.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,248.12 / $3,059.14 / $3,216.67	Facility		$2,248.12	$3,059.14	$3,216.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,164.42 / $2,164.42 / $2,194.06	Facility		$2,164.42	$2,164.42	$2,194.06
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,293.44 / $3,635.58 / $4,388.12	Professional		$2,293.44	$3,635.58	$4,388.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,556.23 / $3,156.18 / $4,124.06	Professional		$2,556.23	$3,156.18	$4,124.06
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 $1,763.97 / $2,793.00 / $4,847.29	Professional		$1,763.97	$2,793.00	$4,847.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,332.58 / $1,673.94 / $1,673.94	Professional		$1,332.58	$1,673.94	$1,673.94