Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $11,773.23 / $26,725.20 / $27,902.60	Facility		$11,773.23	$26,725.20	$27,902.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8,853.93 / $11,773.23 / $27,902.60	Professional		$8,853.93	$11,773.23	$27,902.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $15,863.68 / $29,426.58 / $81,836.25	Facility		$15,863.68	$29,426.58	$81,836.25
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $12,309.11 / $15,863.68 / $89,678.01	Professional		$12,309.11	$15,863.68	$89,678.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $9,812.54 / $9,812.54 / $9,812.54	Facility		$9,812.54	$9,812.54	$9,812.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8,340.66 / $8,340.66 / $9,812.54	Professional		$8,340.66	$8,340.66	$9,812.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $12,483.39 / $19,514.38 / $51,614.20	Facility		$12,483.39	$19,514.38	$51,614.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $12,483.39 / $19,514.38 / $33,850.16	Professional		$12,483.39	$19,514.38	$33,850.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $15,365.63 / $17,482.68 / $19,230.94	Professional		$15,365.63	$17,482.68	$19,230.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $17,292.83 / $17,692.16 / $19,478.65	Facility		$17,292.83	$17,692.16	$19,478.65
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $14,392.19 / $14,392.19 / $14,392.19	Professional		$14,392.19	$14,392.19	$14,392.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $15,038.34 / $15,863.68 / $34,499.71	Facility		$15,038.34	$15,863.68	$34,499.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $15,038.34 / $16,381.63 / $20,345.98	Professional		$15,038.34	$16,381.63	$20,345.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $17,243.82 / $17,692.16 / $17,692.16	Facility		$17,243.82	$17,692.16	$17,692.16
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $14,392.19 / $15,399.25 / $19,928.45	Professional		$14,392.19	$15,399.25	$19,928.45
United Facility/Professional Professional Modifier Low / Median / High Price $7,834.36 / $11,803.99 / $14,946.95	Professional		$7,834.36	$11,803.99	$14,946.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $5,672.80 / $5,672.80 / $5,672.80	Professional		$5,672.80	$5,672.80	$5,672.80