Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,990.01 / $12,418.00 / $24,393.94	Facility		$1,990.01	$12,418.00	$24,393.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,361.75 / $1,789.67 / $3,781.02	Professional		$1,361.75	$1,789.67	$3,781.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,031.87 / $13,922.03 / $28,332.57	Facility		$2,031.87	$13,922.03	$28,332.57
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $849.55 / $1,413.06 / $1,413.06	Facility	AS	$849.55	$1,413.06	$1,413.06
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,817.40 / $3,016.16 / $11,366.67	Professional		$1,817.40	$3,016.16	$11,366.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,925.00 / $1,925.00 / $6,225.54	Facility		$1,925.00	$1,925.00	$6,225.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,372.50 / $2,260.48 / $4,049.22	Professional		$1,372.50	$2,260.48	$4,049.22
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,912.50 / $2,958.59 / $5,459.58	Facility		$1,912.50	$2,958.59	$5,459.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,912.50 / $2,927.27 / $4,616.63	Professional		$1,912.50	$2,927.27	$4,616.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $759.67 / $2,535.03	Professional		$157.37	$759.67	$2,535.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,158.07 / $2,578.29 / $3,314.35	Facility		$2,158.07	$2,578.29	$3,314.35
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,740.88 / $1,740.88 / $1,797.38	Facility		$1,740.88	$1,740.88	$1,797.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,850.08 / $2,967.51 / $3,567.62	Professional		$1,850.08	$2,967.51	$3,567.62
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $9,567.02 / $14,482.75 / $28,332.57	Facility		$9,567.02	$14,482.75	$28,332.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,775.47 / $2,585.56 / $3,697.61	Professional		$1,775.47	$2,585.56	$3,697.61
United Facility/Professional Facility Modifier Low / Median / High Price $2,263.00 / $2,912.00 / $16,315.00	Facility		$2,263.00	$2,912.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,674.98 / $2,201.50 / $3,633.60	Professional		$1,674.98	$2,201.50	$3,633.60