Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,577.31 / $5,850.49 / $6,108.22	Facility		$2,577.31	$5,850.49	$6,108.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,047.56 / $2,577.31 / $6,108.22	Professional		$2,047.56	$2,577.31	$6,108.22
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,472.76 / $7,552.43 / $19,065.24	Facility		$3,472.76	$7,552.43	$19,065.24
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,842.72 / $3,470.72 / $20,393.65	Professional		$2,842.72	$3,470.72	$20,393.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,282.71 / $2,282.71 / $2,282.71	Facility		$2,282.71	$2,282.71	$2,282.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,666.39 / $1,666.39 / $2,572.07	Professional		$1,666.39	$1,666.39	$2,572.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,298.66 / $3,965.99 / $10,460.62	Facility		$2,298.66	$3,965.99	$10,460.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,301.17 / $4,040.08 / $7,751.19	Professional		$2,301.17	$4,040.08	$7,751.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,736.31 / $3,040.35 / $3,344.38	Professional		$2,736.31	$3,040.35	$3,344.38
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,148.11 / $3,873.04 / $4,095.11	Facility		$3,148.11	$3,873.04	$4,095.11
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,371.09 / $3,965.99 / $4,095.11	Professional		$3,371.09	$3,965.99	$4,095.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,472.76 / $4,454.00 / $7,746.08	Facility		$3,472.76	$4,454.00	$7,746.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,774.89 / $3,873.04 / $3,873.04	Facility		$3,774.89	$3,873.04	$3,873.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,150.62 / $3,371.09 / $4,362.59	Professional		$3,150.62	$3,371.09	$4,362.59
United Facility/Professional Facility Modifier Low / Median / High Price $1,982.23 / $1,982.23 / $1,982.23	Facility		$1,982.23	$1,982.23	$1,982.23
United Facility/Professional Professional Modifier Low / Median / High Price $1,822.54 / $2,430.05 / $3,477.16	Professional		$1,822.54	$2,430.05	$3,477.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,207.84 / $2,207.84 / $2,207.84	Professional		$2,207.84	$2,207.84	$2,207.84