Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,132.00 / $22,024.00	Facility		$1,733.00	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,289.33 / $1,770.31 / $3,920.39	Professional		$1,289.33	$1,770.31	$3,920.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,897.00 / $19,823.93 / $38,781.51	Facility		$5,897.00	$19,823.93	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,068.12 / $3,160.02 / $12,394.35	Professional		$2,068.12	$3,160.02	$12,394.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,000.00 / $2,285.42 / $2,500.00	Facility		$2,000.00	$2,285.42	$2,500.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,449.04 / $2,454.98 / $4,153.39	Professional		$1,449.04	$2,454.98	$4,153.39
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,500.75 / $3,012.18 / $6,397.05	Facility		$1,500.75	$3,012.18	$6,397.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,345.50 / $2,914.50 / $5,260.13	Professional		$1,345.50	$2,914.50	$5,260.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $162.32 / $616.32 / $2,869.81	Professional		$162.32	$616.32	$2,869.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,966.10 / $2,651.98 / $2,796.58	Facility		$1,966.10	$2,651.98	$2,796.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,859.11 / $1,907.52 / $6,526.97	Facility		$1,859.11	$1,907.52	$6,526.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,133.81 / $3,036.96 / $3,786.24	Professional		$2,133.81	$3,036.96	$3,786.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,146.66 / $20,262.22 / $38,781.51	Facility		$13,146.66	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,896.05 / $2,738.08 / $3,614.68	Professional		$1,896.05	$2,738.08	$3,614.68
United Facility/Professional Facility Modifier Low / Median / High Price $5,547.00 / $24,764.99 / $40,868.01	Facility		$5,547.00	$24,764.99	$40,868.01
United Facility/Professional Professional Modifier Low / Median / High Price $1,692.18 / $2,296.53 / $4,009.74	Professional		$1,692.18	$2,296.53	$4,009.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,158.38 / $1,158.38 / $1,467.75	Professional		$1,158.38	$1,158.38	$1,467.75