Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,375.73 / $7,662.91 / $8,000.48	Facility		$3,375.73	$7,662.91	$8,000.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,972.42 / $3,375.73 / $8,000.48	Professional		$1,972.42	$3,375.73	$8,000.48
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,548.58 / $9,384.79 / $20,983.29	Facility		$4,548.58	$9,384.79	$20,983.29
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,278.90 / $4,415.42 / $26,681.22	Professional		$3,278.90	$4,415.42	$26,681.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,481.10 / $2,481.10 / $2,481.10	Facility		$2,481.10	$2,481.10	$2,481.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,811.20 / $1,811.20 / $2,481.10	Professional		$1,811.20	$1,811.20	$2,481.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,482.02 / $4,934.88 / $11,295.00	Facility		$2,482.02	$4,934.88	$11,295.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,484.75 / $4,934.88 / $8,370.99	Professional		$2,484.75	$4,934.88	$8,370.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,584.00 / $3,982.23 / $4,380.45	Professional		$3,584.00	$3,982.23	$4,380.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,852.38 / $4,472.24 / $5,194.60	Facility		$3,852.38	$4,472.24	$5,194.60
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,944.84 / $5,194.60 / $5,194.60	Professional		$3,944.84	$5,194.60	$5,194.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,548.58 / $5,833.79 / $10,145.71	Facility		$4,548.58	$5,833.79	$10,145.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,944.31 / $5,072.85 / $5,072.85	Facility		$4,944.31	$5,072.85	$5,072.85
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,126.66 / $4,415.42 / $5,714.07	Professional		$4,126.66	$4,415.42	$5,714.07
United Facility/Professional Facility Modifier Low / Median / High Price $1,516.35 / $2,600.65 / $3,032.69	Facility		$1,516.35	$2,600.65	$3,032.69
United Facility/Professional Professional Modifier Low / Median / High Price $1,968.04 / $2,952.05 / $3,754.76	Professional		$1,968.04	$2,952.05	$3,754.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,714.98 / $2,714.98 / $2,859.80	Professional		$2,714.98	$2,714.98	$2,859.80