Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,540.78 / $4,723.55 / $20,680.40	Facility		$2,540.78	$4,723.55	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,657.18 / $2,442.89 / $4,827.47	Professional		$1,657.18	$2,442.89	$4,827.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,575.19 / $17,300.64	Facility		$55.00	$2,575.19	$17,300.64
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,626.23 / $4,452.79 / $16,604.63	Professional		$2,626.23	$4,452.79	$16,604.63
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 $1,811.53 / $3,310.45 / $5,594.84	Professional		$1,811.53	$3,310.45	$5,594.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,775.06 / $3,646.51 / $4,702.53	Facility		$1,775.06	$3,646.51	$4,702.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,775.06 / $3,640.24 / $4,766.14	Professional		$1,775.06	$3,640.24	$4,766.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $168.26 / $658.44 / $4,170.31	Professional		$168.26	$658.44	$4,170.31
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,633.75 / $3,583.33 / $3,775.45	Facility		$2,633.75	$3,583.33	$3,775.45
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,546.31 / $2,546.31 / $2,575.19	Facility		$2,546.31	$2,546.31	$2,575.19
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,695.92 / $4,270.93 / $5,154.97	Professional		$2,695.92	$4,270.93	$5,154.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,007.24 / $3,704.45 / $4,840.47	Professional		$3,007.24	$3,704.45	$4,840.47
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 $2,085.31 / $3,136.70 / $5,419.36	Professional		$2,085.31	$3,136.70	$5,419.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,563.10 / $1,954.82 / $1,954.82	Professional		$1,563.10	$1,954.82	$1,954.82