Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,425.25 / $6,009.64 / $18,894.28	Facility		$1,425.25	$6,009.64	$18,894.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $767.78 / $1,109.18 / $2,574.08	Professional		$767.78	$1,109.18	$2,574.08
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $25.02 / $121.98 / $920.60	Professional	AS	$25.02	$121.98	$920.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,489.36 / $9,941.33 / $19,448.18	Facility		$1,489.36	$9,941.33	$19,448.18
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $222.35 / $397.38 / $1,052.31	Facility	AS	$222.35	$397.38	$1,052.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,222.56 / $2,249.19 / $8,026.00	Professional		$1,222.56	$2,249.19	$8,026.00
Asuris Northwest Health Facility/Professional Professional Modifier AS Low / Median / High Price $201.13 / $235.28 / $283.00	Professional	AS	$201.13	$235.28	$283.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $644.92 / $2,639.00 / $4,636.17	Facility		$644.92	$2,639.00	$4,636.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,068.27 / $1,653.67 / $2,918.33	Professional		$1,068.27	$1,653.67	$2,918.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,223.00 / $1,886.82 / $3,286.76	Facility		$1,223.00	$1,886.82	$3,286.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,246.08 / $1,988.07 / $3,123.63	Professional		$1,246.08	$1,988.07	$3,123.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.23 / $481.59 / $2,162.71	Professional		$108.23	$481.59	$2,162.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,447.80 / $2,057.57 / $2,824.53	Facility		$1,447.80	$2,057.57	$2,824.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,313.10 / $1,489.36 / $1,961.22	Facility		$1,313.10	$1,489.36	$1,961.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,224.34 / $2,036.20 / $2,730.06	Professional		$1,224.34	$2,036.20	$2,730.06
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,832.97 / $10,161.12 / $19,448.18	Facility		$6,832.97	$10,161.12	$19,448.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,176.71 / $1,694.50 / $2,631.70	Professional		$1,176.71	$1,694.50	$2,631.70
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,691.40 / $20,943.74	Facility		$2,155.00	$12,691.40	$20,943.74
United Facility/Professional Professional Modifier Low / Median / High Price $1,326.99 / $1,637.18 / $3,099.90	Professional		$1,326.99	$1,637.18	$3,099.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $939.02 / $939.02 / $1,191.58	Professional		$939.02	$939.02	$1,191.58