Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,787.75 / $5,128.00 / $20,680.40	Facility		$1,787.75	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,366.40 / $1,787.75 / $4,094.25	Professional		$1,366.40	$1,787.75	$4,094.25
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,433.20 / $18,458.89 / $36,111.08	Facility		$5,433.20	$18,458.89	$36,111.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,143.69 / $3,279.77 / $12,481.05	Professional		$2,143.69	$3,279.77	$12,481.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $7,318.13	Facility		$714.97	$870.49	$7,318.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,556.53 / $2,670.62 / $4,305.29	Professional		$1,556.53	$2,670.62	$4,305.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,536.28 / $3,136.50 / $6,417.76	Facility		$1,536.28	$3,136.50	$6,417.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,399.71 / $2,992.97 / $5,526.27	Professional		$1,399.71	$2,992.97	$5,526.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $150.32 / $608.72 / $2,999.26	Professional		$150.32	$608.72	$2,999.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,029.09 / $2,771.06 / $3,037.11	Facility		$2,029.09	$2,771.06	$3,037.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,809.40 / $1,914.38 / $5,433.20	Facility		$1,809.40	$1,914.38	$5,433.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,188.79 / $3,127.24 / $3,888.74	Professional		$2,188.79	$3,127.24	$3,888.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,241.40 / $18,867.00 / $36,111.08	Facility		$12,241.40	$18,867.00	$36,111.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,952.41 / $2,808.84 / $3,712.54	Professional		$1,952.41	$2,808.84	$3,712.54
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $4,016.00 / $16,315.00	Facility		$2,912.00	$4,016.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,731.48 / $2,316.69 / $4,099.59	Professional		$1,731.48	$2,316.69	$4,099.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,192.60 / $1,192.60 / $1,525.64	Professional		$1,192.60	$1,192.60	$1,525.64