Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,430.35 / $7,786.89 / $8,129.93	Facility		$3,430.35	$7,786.89	$8,129.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,188.69 / $3,430.35 / $8,129.93	Professional		$2,188.69	$3,430.35	$8,129.93
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,622.17 / $8,561.12 / $21,089.02	Facility		$4,622.17	$8,561.12	$21,089.02
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,166.98 / $4,605.79 / $26,129.32	Professional		$3,166.98	$4,605.79	$26,129.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,001.57 / $3,001.57 / $3,001.57	Facility		$3,001.57	$3,001.57	$3,001.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,191.15 / $2,191.15 / $3,001.57	Professional		$2,191.15	$2,191.15	$3,001.57
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,688.00 / $5,278.65 / $14,812.03	Facility		$2,688.00	$5,278.65	$14,812.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,776.36 / $5,057.56 / $8,400.78	Professional		$2,776.36	$5,057.56	$8,400.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,641.99 / $4,046.66 / $4,451.32	Professional		$3,641.99	$4,046.66	$4,451.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,190.08 / $4,750.79 / $5,278.65	Facility		$4,190.08	$4,750.79	$5,278.65
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,377.37 / $4,750.79 / $5,278.65	Professional		$4,377.37	$4,750.79	$5,278.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,381.70 / $4,622.17 / $10,052.12	Facility		$4,381.70	$4,622.17	$10,052.12
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,381.70 / $4,714.60 / $5,928.18	Professional		$4,381.70	$4,714.60	$5,928.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,024.30 / $5,154.93 / $5,154.93	Facility		$5,024.30	$5,154.93	$5,154.93
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,193.43 / $4,486.85 / $5,806.52	Professional		$4,193.43	$4,486.85	$5,806.52
United Facility/Professional Professional Modifier Low / Median / High Price $1,975.10 / $2,609.98 / $3,768.23	Professional		$1,975.10	$2,609.98	$3,768.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3,043.56 / $3,175.07 / $3,175.07	Professional		$3,043.56	$3,175.07	$3,175.07