Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,054.76 / $4,171.77 / $22,024.00	Facility		$2,054.76	$4,171.77	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,493.11 / $2,054.76 / $4,487.43	Professional		$1,493.11	$2,054.76	$4,487.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,332.53 / $17,431.02	Facility		$55.00	$2,332.53	$17,431.02
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,400.92 / $3,932.18 / $15,435.90	Professional		$2,400.92	$3,932.18	$15,435.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $765.00 / $870.49 / $870.49	Facility		$765.00	$870.49	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,660.66 / $2,965.16 / $5,044.03	Professional		$1,660.66	$2,965.16	$5,044.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,540.00 / $2,985.33 / $4,066.67	Facility		$1,540.00	$2,985.33	$4,066.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,543.04 / $2,985.33 / $4,191.18	Professional		$1,543.04	$2,985.33	$4,191.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $176.16 / $701.95 / $3,469.09	Professional		$176.16	$701.95	$3,469.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,208.05 / $2,982.42 / $3,419.68	Facility		$2,208.05	$2,982.42	$3,419.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,251.41 / $2,251.41 / $2,332.53	Facility		$2,251.41	$2,251.41	$2,332.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,595.21 / $3,710.61 / $4,629.84	Professional		$2,595.21	$3,710.61	$4,629.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,296.14 / $3,320.05 / $4,420.06	Professional		$2,296.14	$3,320.05	$4,420.06
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 $1,937.88 / $2,758.19 / $4,799.39	Professional		$1,937.88	$2,758.19	$4,799.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,416.23 / $1,416.23 / $1,786.33	Professional		$1,416.23	$1,416.23	$1,786.33