Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,594.05 / $2,868.97 / $5,291.29	Facility		$2,594.05	$2,868.97	$5,291.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,634.24 / $3,161.99	Professional		$2,608.16	$2,634.24	$3,161.99
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,387.73 / $3,805.61 / $13,367.15	Facility		$2,387.73	$3,805.61	$13,367.15
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,868.98 / $12,064.38	Professional		$2,608.16	$2,868.98	$12,064.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,460.53 / $2,608.16 / $6,626.39	Facility		$2,460.53	$2,608.16	$6,626.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,608.16 / $3,198.68	Professional		$2,608.16	$2,608.16	$3,198.68
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,060.44 / $2,738.57 / $7,034.64	Facility		$2,060.44	$2,738.57	$7,034.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,931.39 / $2,738.57 / $5,521.90	Professional		$1,931.39	$2,738.57	$5,521.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $2,868.97 / $3,434.25	Professional		$75.00	$2,868.97	$3,434.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,543.89 / $2,952.63 / $5,424.97	Facility		$2,543.89	$2,952.63	$5,424.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,934.45 / $3,637.04 / $6,364.83	Facility		$1,934.45	$3,637.04	$6,364.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,887.20 / $3,480.11 / $6,289.98	Professional		$2,887.20	$3,480.11	$6,289.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,537.07 / $2,984.66 / $5,074.14	Facility		$2,537.07	$2,984.66	$5,074.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,868.98 / $3,129.79	Professional		$2,608.16	$2,868.98	$3,129.79
United Facility/Professional Facility Modifier Low / Median / High Price $4,411.16 / $4,411.16 / $4,411.16	Facility		$4,411.16	$4,411.16	$4,411.16
United Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,608.16 / $3,129.79	Professional		$2,608.16	$2,608.16	$3,129.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,608.16 / $2,608.16 / $2,732.53	Professional		$2,608.16	$2,608.16	$2,732.53