Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,265.63 / $4,209.28 / $20,680.40	Facility		$2,265.63	$4,209.28	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,462.93 / $2,158.08 / $4,304.70	Professional		$1,462.93	$2,158.08	$4,304.70
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,270.38 / $13,366.99	Facility		$55.00	$2,270.38	$13,366.99
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,382.71 / $3,996.02 / $14,627.25	Professional		$2,382.71	$3,996.02	$14,627.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $714.97 / $947.00	Facility		$500.00	$714.97	$947.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,596.12 / $2,928.69 / $4,949.64	Professional		$1,596.12	$2,928.69	$4,949.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,558.37 / $3,122.84 / $4,164.02	Facility		$1,558.37	$3,122.84	$4,164.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,558.37 / $3,122.84 / $4,168.28	Professional		$1,558.37	$3,122.84	$4,168.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $168.30 / $619.82 / $3,673.38	Professional		$168.30	$619.82	$3,673.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,315.25 / $3,170.77 / $3,328.56	Facility		$2,315.25	$3,170.77	$3,328.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,248.69 / $2,248.69 / $2,270.38	Facility		$2,248.69	$2,248.69	$2,270.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,379.41 / $3,769.50 / $4,549.75	Professional		$2,379.41	$3,769.50	$4,549.75
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,655.74 / $3,265.97 / $4,267.51	Professional		$2,655.74	$3,265.97	$4,267.51
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 $1,815.11 / $2,946.31 / $4,851.74	Professional		$1,815.11	$2,946.31	$4,851.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,379.23 / $1,740.75 / $1,740.75	Professional		$1,379.23	$1,740.75	$1,740.75