Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,868.51 / $6,511.52 / $6,798.37	Facility		$2,868.51	$6,511.52	$6,798.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,808.63 / $2,868.51 / $6,798.37	Professional		$1,808.63	$2,868.51	$6,798.37
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,865.13 / $7,974.67 / $17,674.86	Facility		$3,865.13	$7,974.67	$17,674.86
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,588.12 / $3,751.98 / $22,536.86	Professional		$2,588.12	$3,751.98	$22,536.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,482.86 / $2,482.86 / $2,482.86	Facility		$2,482.86	$2,482.86	$2,482.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,812.49 / $1,812.49 / $2,482.86	Professional		$1,812.49	$1,812.49	$2,482.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,082.98 / $4,193.39 / $9,479.06	Facility		$2,082.98	$4,193.39	$9,479.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,085.27 / $4,193.39 / $7,025.47	Professional		$2,085.27	$4,193.39	$7,025.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,045.49 / $3,383.88 / $3,722.26	Professional		$3,045.49	$3,383.88	$3,722.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,503.80 / $3,972.68 / $4,414.09	Facility		$3,503.80	$3,972.68	$4,414.09
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,617.25 / $4,414.09 / $4,414.09	Professional		$3,617.25	$4,414.09	$4,414.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,865.13 / $4,957.22 / $8,621.26	Facility		$3,865.13	$4,957.22	$8,621.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,201.39 / $4,310.63 / $4,310.63	Facility		$4,201.39	$4,310.63	$4,310.63
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,506.61 / $3,751.98 / $4,855.50	Professional		$3,506.61	$3,751.98	$4,855.50
United Facility/Professional Facility Modifier Low / Median / High Price $1,272.54 / $2,182.50 / $2,545.08	Facility		$1,272.54	$2,182.50	$2,545.08
United Facility/Professional Professional Modifier Low / Median / High Price $1,651.61 / $2,488.46 / $3,151.05	Professional		$1,651.61	$2,488.46	$3,151.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,353.05 / $1,353.05 / $1,988.34	Professional		$1,353.05	$1,353.05	$1,988.34