Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,090.67 / $12,369.57 / $19,900.00	Facility		$2,090.67	$12,369.57	$19,900.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,181.34 / $1,550.11 / $3,598.09	Professional		$1,181.34	$1,550.11	$3,598.09
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,793.08 / $11,266.46 / $22,040.55	Facility		$1,793.08	$11,266.46	$22,040.55
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $676.94 / $1,125.97 / $1,125.97	Facility	AS	$676.94	$1,125.97	$1,125.97
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,562.03 / $2,640.37 / $11,185.05	Professional		$1,562.03	$2,640.37	$11,185.05
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 $1,146.07 / $1,944.42 / $3,481.28	Professional		$1,146.07	$1,944.42	$3,481.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,645.00 / $2,459.53 / $4,350.34	Facility		$1,645.00	$2,459.53	$4,350.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,645.00 / $2,459.53 / $3,766.56	Professional		$1,645.00	$2,459.53	$3,766.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $141.32 / $754.32 / $2,212.70	Professional		$141.32	$754.32	$2,212.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,856.36 / $2,211.67 / $2,876.90	Facility		$1,856.36	$2,211.67	$2,876.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,496.26 / $1,496.26 / $1,793.08	Facility		$1,496.26	$1,496.26	$1,793.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,590.42 / $2,550.54 / $3,066.91	Professional		$1,590.42	$2,550.54	$3,066.91
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 $1,525.99 / $2,222.67 / $3,171.48	Professional		$1,525.99	$2,222.67	$3,171.48
United Facility/Professional Facility Modifier Low / Median / High Price $2,495.00 / $14,102.05 / $23,014.06	Facility		$2,495.00	$14,102.05	$23,014.06
United Facility/Professional Professional Modifier Low / Median / High Price $1,440.76 / $1,914.50 / $3,184.40	Professional		$1,440.76	$1,914.50	$3,184.40