Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,208.81 / $4,154.14 / $20,680.40	Facility		$2,208.81	$4,154.14	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,450.40 / $2,208.81 / $4,154.14	Professional		$1,450.40	$2,208.81	$4,154.14
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,237.02 / $16,912.25	Facility		$55.00	$2,237.02	$16,912.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,341.44 / $3,866.54 / $14,422.35	Professional		$2,341.44	$3,866.54	$14,422.35
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 $1,631.51 / $2,877.69 / $4,863.45	Professional		$1,631.51	$2,877.69	$4,863.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,537.29 / $3,135.63 / $4,085.98	Facility		$1,537.29	$3,135.63	$4,085.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,537.29 / $3,135.63 / $4,125.14	Professional		$1,537.29	$3,135.63	$4,125.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $134.52 / $555.11 / $3,598.13	Professional		$134.52	$555.11	$3,598.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,309.37 / $3,114.87 / $3,279.65	Facility		$2,309.37	$3,114.87	$3,279.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,209.73 / $2,209.73 / $2,237.02	Facility		$2,209.73	$2,209.73	$2,237.02
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,340.98 / $3,708.63 / $4,476.28	Professional		$2,340.98	$3,708.63	$4,476.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,609.73 / $3,217.97 / $4,219.47	Professional		$2,609.73	$3,217.97	$4,219.47
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $1,323.00 / $4,332.00	Facility		$650.00	$1,323.00	$4,332.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,766.58 / $2,736.45 / $4,705.84	Professional		$1,766.58	$2,736.45	$4,705.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,357.97 / $1,701.49 / $1,701.49	Professional		$1,357.97	$1,701.49	$1,701.49