Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,115.21 / $4,500.00 / $22,024.00	Facility		$2,115.21	$4,500.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,570.89 / $2,115.21 / $4,782.54	Professional		$1,570.89	$2,115.21	$4,782.54
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $5,000.00 / $21,960.84	Facility		$55.00	$5,000.00	$21,960.84
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,496.98 / $4,073.82 / $15,972.53	Professional		$2,496.98	$4,073.82	$15,972.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,000.00 / $2,285.42 / $2,285.42	Facility		$2,000.00	$2,285.42	$2,285.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,759.74 / $3,054.00 / $5,193.47	Professional		$1,759.74	$3,054.00	$5,193.47
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,626.11 / $3,277.81 / $4,175.60	Facility		$1,626.11	$3,277.81	$4,175.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,642.69 / $3,307.57 / $4,331.22	Professional		$1,642.69	$3,307.57	$4,331.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $261.34 / $1,713.02 / $3,780.72	Professional		$261.34	$1,713.02	$3,780.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,467.15 / $3,289.88 / $3,531.57	Facility		$2,467.15	$3,289.88	$3,531.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,326.61 / $2,326.61 / $2,408.85	Facility		$2,326.61	$2,326.61	$2,408.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,681.01 / $3,832.02 / $4,781.32	Professional		$2,681.01	$3,832.02	$4,781.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,372.83 / $3,428.68 / $4,564.68	Professional		$2,372.83	$3,428.68	$4,564.68
United Facility/Professional Facility Modifier Low / Median / High Price $702.00 / $1,389.00 / $5,793.00	Facility		$702.00	$1,389.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,089.37 / $2,838.02 / $4,957.09	Professional		$2,089.37	$2,838.02	$4,957.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,461.23 / $1,461.23 / $1,830.99	Professional		$1,461.23	$1,461.23	$1,830.99