Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,061.36 / $4,061.36 / $4,061.36	Facility		$4,061.36	$4,061.36	$4,061.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,692.14 / $4,061.36 / $4,114.50	Professional		$3,692.14	$4,061.36	$4,114.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,907.00 / $3,896.15 / $12,825.00	Facility		$2,907.00	$3,896.15	$12,825.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,322.93 / $3,692.14 / $13,680.00	Professional		$3,322.93	$3,692.14	$13,680.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,483.15 / $3,483.15 / $5,858.04	Facility		$3,483.15	$3,483.15	$5,858.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,692.14 / $3,692.14 / $4,528.10	Professional		$3,692.14	$3,692.14	$4,528.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,692.14 / $3,692.14 / $4,984.39	Facility		$3,692.14	$3,692.14	$4,984.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,692.14 / $3,692.14 / $4,615.18	Professional		$3,692.14	$3,692.14	$4,615.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Professional		$50.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,692.14 / $3,774.77 / $7,662.93	Facility		$3,692.14	$3,774.77	$7,662.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,838.60 / $2,838.60 / $2,907.00	Facility		$2,838.60	$2,838.60	$2,907.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,633.40 / $2,907.00 / $3,078.00	Professional		$2,633.40	$2,907.00	$3,078.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,692.14 / $3,692.14 / $3,692.14	Facility		$3,692.14	$3,692.14	$3,692.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,507.53 / $3,692.14 / $3,692.14	Professional		$3,507.53	$3,692.14	$3,692.14
United Facility/Professional Facility Modifier Low / Median / High Price $2,929.02 / $2,929.02 / $2,929.02	Facility		$2,929.02	$2,929.02	$2,929.02
United Facility/Professional Professional Modifier Low / Median / High Price $3,692.14 / $3,692.14 / $4,430.57	Professional		$3,692.14	$3,692.14	$4,430.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,989.20 / $3,692.14 / $3,692.14	Professional		$2,989.20	$3,692.14	$3,692.14