Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,295.20 / $12,020.10 / $12,549.60	Facility		$5,295.20	$12,020.10	$12,549.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,052.67 / $5,295.20 / $12,549.60	Professional		$4,052.67	$5,295.20	$12,549.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $7,134.95 / $16,483.03 / $34,402.54	Facility		$7,134.95	$16,483.03	$34,402.54
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,963.27 / $6,926.06 / $52,107.80	Professional		$4,963.27	$6,926.06	$52,107.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,728.96 / $4,728.96 / $4,728.96	Facility		$4,728.96	$4,728.96	$4,728.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,452.14 / $3,452.14 / $4,728.96	Professional		$3,452.14	$3,452.14	$4,728.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,844.75 / $7,740.89 / $17,497.50	Facility		$3,844.75	$7,740.89	$17,497.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,848.97 / $7,740.89 / $12,968.58	Professional		$3,848.97	$7,740.89	$12,968.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $5,621.90 / $6,246.56 / $6,871.21	Professional		$5,621.90	$6,246.56	$6,871.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $6,467.94 / $7,957.34 / $8,148.31	Facility		$6,467.94	$7,957.34	$8,148.31
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $8,105.34 / $8,148.31 / $8,963.14	Professional		$8,105.34	$8,148.31	$8,963.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,134.95 / $9,150.94 / $15,914.68	Facility		$7,134.95	$9,150.94	$15,914.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,755.69 / $7,957.34 / $7,957.34	Facility		$7,755.69	$7,957.34	$7,957.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $6,473.12 / $6,926.06 / $8,963.14	Professional		$6,473.12	$6,926.06	$8,963.14
United Facility/Professional Facility Modifier Low / Median / High Price $8,148.31 / $9,777.96 / $9,777.96	Facility		$8,148.31	$9,777.96	$9,777.96
United Facility/Professional Professional Modifier Low / Median / High Price $3,048.83 / $4,592.63 / $5,816.77	Professional		$3,048.83	$4,592.63	$5,816.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3,226.51 / $3,226.51 / $3,670.43	Professional		$3,226.51	$3,226.51	$3,670.43