Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,173.84 / $4,934.62 / $5,152.00	Facility		$2,173.84	$4,934.62	$5,152.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,732.43 / $2,173.84 / $5,152.00	Professional		$1,732.43	$2,173.84	$5,152.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,929.12 / $6,370.12 / $16,018.84	Facility		$2,929.12	$6,370.12	$16,018.84
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,382.13 / $2,927.39 / $17,255.00	Professional		$2,382.13	$2,927.39	$17,255.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,217.07 / $2,217.07 / $2,217.07	Facility		$2,217.07	$2,217.07	$2,217.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,618.46 / $1,618.46 / $2,217.07	Professional		$1,618.46	$1,618.46	$2,217.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,926.47 / $3,345.13 / $8,766.56	Facility		$1,926.47	$3,345.13	$8,766.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,928.58 / $3,385.92 / $6,496.70	Professional		$1,928.58	$3,385.92	$6,496.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,307.96 / $2,564.40 / $2,820.84	Professional		$2,307.96	$2,564.40	$2,820.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,655.29 / $3,266.73 / $3,464.86	Facility		$2,655.29	$3,266.73	$3,464.86
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,345.13 / $3,345.13 / $3,464.86	Professional		$3,345.13	$3,345.13	$3,464.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,929.12 / $3,756.74 / $6,533.46	Facility		$2,929.12	$3,756.74	$6,533.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,183.95 / $3,266.73 / $3,266.73	Facility		$3,183.95	$3,266.73	$3,266.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,657.41 / $2,843.36 / $3,679.64	Professional		$2,657.41	$2,843.36	$3,679.64
United Facility/Professional Facility Modifier Low / Median / High Price $1,176.86 / $2,018.42 / $2,353.73	Facility		$1,176.86	$2,018.42	$2,353.73
United Facility/Professional Professional Modifier Low / Median / High Price $1,527.44 / $2,291.16 / $2,914.15	Professional		$1,527.44	$2,291.16	$2,914.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,847.98 / $1,847.98 / $2,843.36	Professional		$1,847.98	$1,847.98	$2,843.36