Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,124.56 / $5,551.08 / $18,315.20	Facility		$3,124.56	$5,551.08	$18,315.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $3,124.56 / $5,295.46	Professional		$1,000.00	$3,124.56	$5,295.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,490.20 / $5,454.68 / $15,789.00	Facility		$3,490.20	$5,454.68	$15,789.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,329.60 / $3,490.20 / $16,620.00	Professional		$1,329.60	$3,490.20	$16,620.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,456.96 / $6,805.89 / $8,642.40	Facility		$3,456.96	$6,805.89	$8,642.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,061.19 / $3,819.42 / $4,774.28	Professional		$2,061.19	$3,819.42	$4,774.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,280.11 / $4,155.00 / $9,487.98	Facility		$3,280.11	$4,155.00	$9,487.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,324.00 / $4,886.28 / $9,198.33	Professional		$3,324.00	$4,886.28	$9,198.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,324.00 / $3,324.00 / $6,980.40	Facility		$3,324.00	$3,324.00	$6,980.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,324.00 / $4,986.00 / $9,141.00	Facility		$3,324.00	$4,986.00	$9,141.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,991.60 / $3,988.80 / $4,720.08	Professional		$2,991.60	$3,988.80	$4,720.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,490.20 / $5,454.68 / $9,141.00	Facility		$3,490.20	$5,454.68	$9,141.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,009.12 / $5,846.80 / $8,141.47	Professional		$3,009.12	$5,846.80	$8,141.47
United Facility/Professional Facility Modifier Low / Median / High Price $3,324.00 / $3,988.80 / $3,988.80	Facility		$3,324.00	$3,988.80	$3,988.80
United Facility/Professional Professional Modifier Low / Median / High Price $1,396.08 / $1,396.08 / $3,722.88	Professional		$1,396.08	$1,396.08	$3,722.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,495.80 / $1,495.80 / $1,721.83	Professional		$1,495.80	$1,495.80	$1,721.83