Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,360.32 / $4,306.53 / $20,680.40	Facility		$2,360.32	$4,306.53	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,542.81 / $2,267.08 / $4,484.60	Professional		$1,542.81	$2,267.08	$4,484.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,394.21 / $16,091.60	Facility		$55.00	$2,394.21	$16,091.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,503.80 / $4,135.47 / $15,436.13	Professional		$2,503.80	$4,135.47	$15,436.13
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 $1,737.05 / $3,081.03 / $5,207.10	Professional		$1,737.05	$3,081.03	$5,207.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,637.11 / $3,324.32 / $4,372.39	Facility		$1,637.11	$3,324.32	$4,372.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,637.11 / $3,324.32 / $4,391.93	Professional		$1,637.11	$3,324.32	$4,391.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $168.26 / $642.06 / $3,857.23	Professional		$168.26	$642.06	$3,857.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,469.60 / $3,224.04 / $3,510.13	Facility		$2,469.60	$3,224.04	$3,510.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,362.85 / $2,362.85 / $2,394.21	Facility		$2,362.85	$2,362.85	$2,394.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,503.67 / $3,966.57 / $4,787.62	Professional		$2,503.67	$3,966.57	$4,787.62
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,790.56 / $3,444.12 / $4,500.30	Professional		$2,790.56	$3,444.12	$4,500.30
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 $1,915.21 / $3,051.61 / $5,108.89	Professional		$1,915.21	$3,051.61	$5,108.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,452.67 / $1,822.31 / $1,822.31	Professional		$1,452.67	$1,822.31	$1,822.31