Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,943.01 / $6,680.63 / $6,974.93	Facility		$2,943.01	$6,680.63	$6,974.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,162.33 / $2,943.01 / $6,974.93	Professional		$2,162.33	$2,943.01	$6,974.93
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,965.52 / $7,978.54 / $21,030.00	Facility		$3,965.52	$7,978.54	$21,030.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,170.11 / $3,989.27 / $27,812.52	Professional		$3,170.11	$3,989.27	$27,812.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,741.63 / $2,741.63 / $2,741.63	Facility		$2,741.63	$2,741.63	$2,741.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,001.39 / $2,001.39 / $2,741.63	Professional		$2,001.39	$2,001.39	$2,741.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,796.96 / $4,776.39 / $12,409.89	Facility		$2,796.96	$4,776.39	$12,409.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,955.23 / $4,854.20 / $8,941.95	Professional		$2,955.23	$4,854.20	$8,941.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,124.58 / $3,471.76 / $3,818.93	Professional		$3,124.58	$3,471.76	$3,818.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,075.86 / $4,422.59 / $4,528.72	Facility		$4,075.86	$4,422.59	$4,528.72
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,597.68 / $3,597.68 / $3,597.68	Professional		$3,597.68	$3,597.68	$3,597.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,759.20 / $3,965.52 / $8,624.04	Facility		$3,759.20	$3,965.52	$8,624.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,759.20 / $4,044.83 / $5,085.97	Professional		$3,759.20	$4,044.83	$5,085.97
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,310.52 / $4,422.59 / $4,422.59	Facility		$4,310.52	$4,422.59	$4,422.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,597.68 / $3,849.42 / $4,981.60	Professional		$3,597.68	$3,849.42	$4,981.60
United Facility/Professional Professional Modifier Low / Median / High Price $2,102.33 / $3,166.86 / $4,010.97	Professional		$2,102.33	$3,166.86	$4,010.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,774.80 / $2,774.80 / $3,849.42	Professional		$2,774.80	$2,774.80	$3,849.42