Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,063.72 / $6,954.64 / $7,261.02	Facility		$3,063.72	$6,954.64	$7,261.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,441.63 / $3,063.72 / $7,261.02	Professional		$2,441.63	$3,063.72	$7,261.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,128.16 / $8,977.76 / $22,493.11	Facility		$4,128.16	$8,977.76	$22,493.11
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,357.29 / $4,125.74 / $24,318.59	Professional		$3,357.29	$4,125.74	$24,318.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,886.72 / $2,886.72 / $2,886.72	Facility		$2,886.72	$2,886.72	$2,886.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,107.31 / $2,107.31 / $2,886.72	Professional		$2,107.31	$2,107.31	$2,886.72
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,714.98 / $4,714.47 / $12,354.37	Facility		$2,714.98	$4,714.47	$12,354.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,717.96 / $4,771.80 / $9,156.28	Professional		$2,717.96	$4,771.80	$9,156.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,252.73 / $3,614.15 / $3,975.56	Professional		$3,252.73	$3,614.15	$3,975.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,243.03 / $4,714.47 / $4,883.25	Facility		$4,243.03	$4,714.47	$4,883.25
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,745.23 / $3,745.23 / $3,745.23	Professional		$3,745.23	$3,745.23	$3,745.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,128.16 / $5,294.58 / $9,207.95	Facility		$4,128.16	$5,294.58	$9,207.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,487.31 / $4,603.97 / $4,603.97	Facility		$4,487.31	$4,603.97	$4,603.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,745.23 / $4,007.31 / $5,185.93	Professional		$3,745.23	$4,007.31	$5,185.93
United Facility/Professional Facility Modifier Low / Median / High Price $5,753.36 / $6,904.03 / $6,904.03	Facility		$5,753.36	$6,904.03	$6,904.03
United Facility/Professional Professional Modifier Low / Median / High Price $2,152.71 / $3,242.76 / $4,107.10	Professional		$2,152.71	$3,242.76	$4,107.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,902.12 / $2,902.12 / $2,902.12	Professional		$2,902.12	$2,902.12	$2,902.12