Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,001.13 / $5,128.00 / $22,024.00	Facility		$2,001.13	$5,128.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,278.38 / $1,922.86 / $3,802.15	Professional		$1,278.38	$1,922.86	$3,802.15
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,030.45 / $13,645.60	Facility		$55.00	$2,030.45	$13,645.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,064.52 / $3,500.46 / $13,089.08	Professional		$2,064.52	$3,500.46	$13,089.08
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 $1,478.79 / $2,612.04 / $4,414.49	Professional		$1,478.79	$2,612.04	$4,414.49
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,393.14 / $2,882.19 / $3,706.97	Facility		$1,393.14	$2,882.19	$3,706.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,393.14 / $2,856.10 / $3,739.48	Professional		$1,393.14	$2,856.10	$3,739.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $184.51 / $1,666.86 / $3,400.18	Professional		$184.51	$1,666.86	$3,400.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,044.28 / $2,688.40 / $2,976.81	Facility		$2,044.28	$2,688.40	$2,976.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,004.07 / $2,004.07 / $2,030.45	Facility		$2,004.07	$2,004.07	$2,030.45
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,123.52 / $3,364.70 / $4,061.16	Professional		$2,123.52	$3,364.70	$4,061.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,366.84 / $2,920.83 / $3,816.54	Professional		$2,366.84	$2,920.83	$3,816.54
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 $1,582.49 / $2,549.39 / $4,269.43	Professional		$1,582.49	$2,549.39	$4,269.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,234.02 / $1,546.04 / $1,546.04	Professional		$1,234.02	$1,546.04	$1,546.04