Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,523.58 / $5,728.53 / $5,980.88	Facility		$2,523.58	$5,728.53	$5,980.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,569.64 / $2,523.58 / $5,980.88	Professional		$1,569.64	$2,523.58	$5,980.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,400.36 / $7,073.05 / $15,534.23	Facility		$3,400.36	$7,073.05	$15,534.23
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,274.69 / $3,300.81 / $19,222.38	Professional		$2,274.69	$3,300.81	$19,222.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,819.89 / $1,819.89 / $1,819.89	Facility		$1,819.89	$1,819.89	$1,819.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,328.52 / $1,328.52 / $1,819.89	Professional		$1,328.52	$1,328.52	$1,819.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,832.28 / $3,689.14 / $8,338.12	Facility		$1,832.28	$3,689.14	$8,338.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,834.29 / $3,689.14 / $6,179.77	Professional		$1,834.29	$3,689.14	$6,179.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,679.28 / $2,976.98 / $3,274.67	Professional		$2,679.28	$2,976.98	$3,274.67
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,065.70 / $3,494.98 / $3,883.31	Facility		$3,065.70	$3,494.98	$3,883.31
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,139.28 / $3,883.31 / $3,883.31	Professional		$3,139.28	$3,883.31	$3,883.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,400.36 / $4,361.14 / $7,584.60	Facility		$3,400.36	$4,361.14	$7,584.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,696.20 / $3,792.30 / $3,792.30	Facility		$3,696.20	$3,792.30	$3,792.30
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,084.95 / $3,300.81 / $4,271.64	Professional		$3,084.95	$3,300.81	$4,271.64
United Facility/Professional Facility Modifier Low / Median / High Price $1,776.27 / $1,776.27 / $1,776.27	Facility		$1,776.27	$1,776.27	$1,776.27
United Facility/Professional Professional Modifier Low / Median / High Price $1,453.01 / $2,179.51 / $2,772.15	Professional		$1,453.01	$2,179.51	$2,772.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,353.05 / $1,353.05 / $1,760.19	Professional		$1,353.05	$1,353.05	$1,760.19