Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,160.13 / $12,757.68 / $27,948.51	Facility		$2,160.13	$12,757.68	$27,948.51
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,317.97 / $1,941.02 / $2,531.66	Facility	54	$1,317.97	$1,941.02	$2,531.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $915.97 / $1,281.43 / $2,982.23	Professional		$915.97	$1,281.43	$2,982.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,684.26 / $11,266.46 / $22,040.55	Facility		$1,684.26	$11,266.46	$22,040.55
Asuris Northwest Health Facility/Professional Facility Modifier 54 Low / Median / High Price $4,738.57 / $7,881.75 / $7,881.75	Facility	54	$4,738.57	$7,881.75	$7,881.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,646.87 / $2,747.20 / $9,928.20	Professional		$1,646.87	$2,747.20	$9,928.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,925.00 / $1,925.00 / $4,960.67	Facility		$1,925.00	$1,925.00	$4,960.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,177.45 / $1,874.55 / $3,606.16	Professional		$1,177.45	$1,874.55	$3,606.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,418.00 / $2,357.48 / $4,350.34	Facility		$1,418.00	$2,357.48	$4,350.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,418.00 / $2,357.48 / $3,678.65	Professional		$1,418.00	$2,357.48	$3,678.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $141.32 / $791.68 / $2,337.81	Professional		$141.32	$791.68	$2,337.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,644.93 / $2,246.51 / $2,345.67	Facility		$1,644.93	$2,246.51	$2,345.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,542.92 / $1,542.92 / $1,684.26	Facility		$1,542.92	$1,542.92	$1,684.26
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,646.87 / $2,635.00 / $3,175.76	Professional		$1,646.87	$2,635.00	$3,175.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,407.53 / $11,522.14 / $22,040.55	Facility		$8,407.53	$11,522.14	$22,040.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,573.57 / $2,301.56 / $3,100.14	Professional		$1,573.57	$2,301.56	$3,100.14
United Facility/Professional Facility Modifier Low / Median / High Price $2,263.00 / $3,501.00 / $16,315.00	Facility		$2,263.00	$3,501.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,374.00 / $1,805.77 / $3,310.57	Professional		$1,374.00	$1,805.77	$3,310.57