Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,932.50 / $5,555.32 / $22,024.00	Facility		$2,932.50	$5,555.32	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,137.16 / $2,932.50 / $6,536.24	Professional		$2,137.16	$2,932.50	$6,536.24
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $5,000.00 / $24,915.15	Facility		$55.00	$5,000.00	$24,915.15
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,495.81 / $5,522.61 / $22,202.25	Professional		$3,495.81	$5,522.61	$22,202.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $765.00 / $2,285.42	Facility		$714.97	$765.00	$2,285.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,418.42 / $4,239.14 / $7,195.19	Professional		$2,418.42	$4,239.14	$7,195.19
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,235.52 / $4,382.05 / $5,805.98	Facility		$2,235.52	$4,382.05	$5,805.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,235.69 / $4,382.05 / $6,011.93	Professional		$2,235.69	$4,382.05	$6,011.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $282.19 / $1,039.09 / $4,935.20	Professional		$282.19	$1,039.09	$4,935.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,311.42 / $4,255.97 / $4,903.06	Facility		$3,311.42	$4,255.97	$4,903.06
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,238.95 / $3,238.95 / $3,344.33	Facility		$3,238.95	$3,238.95	$3,344.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,728.79 / $5,320.19 / $6,638.16	Professional		$3,728.79	$5,320.19	$6,638.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,303.30 / $4,760.22 / $6,337.39	Professional		$3,303.30	$4,760.22	$6,337.39
United Facility/Professional Facility Modifier Low / Median / High Price $702.00 / $1,323.00 / $5,793.00	Facility		$702.00	$1,323.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,803.13 / $3,991.89 / $7,007.59	Professional		$2,803.13	$3,991.89	$7,007.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,029.10 / $2,029.10 / $2,529.53	Professional		$2,029.10	$2,029.10	$2,529.53