Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,275.23 / $4,500.00 / $22,024.00	Facility		$2,275.23	$4,500.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,694.40 / $2,394.33 / $4,993.77	Professional		$1,694.40	$2,394.33	$4,993.77
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,586.16 / $19,311.93	Facility		$55.00	$2,586.16	$19,311.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,661.99 / $4,365.09 / $17,128.34	Professional		$2,661.99	$4,365.09	$17,128.34
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 $1,859.43 / $3,285.43 / $5,585.83	Professional		$1,859.43	$3,285.43	$5,585.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,714.24 / $3,480.22 / $4,499.47	Facility		$1,714.24	$3,480.22	$4,499.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,748.09 / $3,480.22 / $4,659.64	Professional		$1,748.09	$3,480.22	$4,659.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $193.45 / $745.56 / $3,805.79	Professional		$193.45	$745.56	$3,805.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,459.81 / $3,401.59 / $3,791.53	Facility		$2,459.81	$3,401.59	$3,791.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,497.84 / $2,497.84 / $2,586.16	Facility		$2,497.84	$2,497.84	$2,586.16
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,878.77 / $4,114.09 / $5,133.28	Professional		$2,878.77	$4,114.09	$5,133.28
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,547.46 / $3,681.07 / $4,900.68	Professional		$2,547.46	$3,681.07	$4,900.68
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 $2,203.98 / $3,058.12 / $5,323.81	Professional		$2,203.98	$3,058.12	$5,323.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,569.45 / $1,569.45 / $1,974.50	Professional		$1,569.45	$1,569.45	$1,974.50