Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,349.32 / $5,332.96 / $5,567.89	Facility		$2,349.32	$5,332.96	$5,567.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,691.85 / $2,349.32 / $5,567.89	Professional		$1,691.85	$2,349.32	$5,567.89
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,165.56 / $6,884.32 / $16,837.56	Facility		$3,165.56	$6,884.32	$16,837.56
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,368.58 / $3,145.18 / $22,332.37	Professional		$2,368.58	$3,145.18	$22,332.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,375.33 / $2,375.33 / $2,375.33	Facility		$2,375.33	$2,375.33	$2,375.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,733.99 / $1,733.99 / $2,375.33	Professional		$1,733.99	$1,733.99	$2,375.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,128.94 / $3,624.96 / $9,688.12	Facility		$2,128.94	$3,624.96	$9,688.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,131.28 / $3,687.45 / $7,179.39	Professional		$2,131.28	$3,687.45	$7,179.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,494.26 / $2,771.41 / $3,048.55	Professional		$2,494.26	$2,771.41	$3,048.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,253.64 / $3,530.42 / $3,615.15	Facility		$3,253.64	$3,530.42	$3,615.15
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,871.93 / $2,871.93 / $2,871.93	Professional		$2,871.93	$2,871.93	$2,871.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,165.56 / $4,059.98 / $7,060.84	Facility		$3,165.56	$4,059.98	$7,060.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,440.96 / $3,530.42 / $3,530.42	Facility		$3,440.96	$3,530.42	$3,530.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,871.93 / $3,072.88 / $3,976.67	Professional		$2,871.93	$3,072.88	$3,976.67
United Facility/Professional Facility Modifier Low / Median / High Price $4,511.59 / $5,413.91 / $5,413.91	Facility		$4,511.59	$5,413.91	$5,413.91
United Facility/Professional Professional Modifier Low / Median / High Price $1,688.09 / $2,415.57 / $3,220.65	Professional		$1,688.09	$2,415.57	$3,220.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,057.46 / $1,057.46 / $3,072.88	Professional		$1,057.46	$1,057.46	$3,072.88