Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,527.50 / $4,500.00 / $18,800.00	Facility		$1,527.50	$4,500.00	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $801.75 / $1,467.28 / $2,385.69	Professional		$801.75	$1,467.28	$2,385.69
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,950.02 / $9,941.33 / $19,448.18	Facility		$1,950.02	$9,941.33	$19,448.18
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,315.27 / $2,753.24 / $10,575.60	Professional		$1,315.27	$2,753.24	$10,575.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $644.92 / $1,110.00 / $4,636.17	Facility		$644.92	$1,110.00	$4,636.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,151.34 / $1,993.97 / $3,784.65	Professional		$1,151.34	$1,993.97	$3,784.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,369.66 / $2,364.56 / $4,366.92	Facility		$1,369.66	$2,364.56	$4,366.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,375.78 / $2,379.98 / $4,366.92	Professional		$1,375.78	$2,379.98	$4,366.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $145.62 / $746.31 / $2,821.69	Professional		$145.62	$746.31	$2,821.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,715.33 / $2,753.43 / $2,895.44	Facility		$1,715.33	$2,753.43	$2,895.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,313.10 / $1,950.02 / $1,961.22	Facility		$1,313.10	$1,950.02	$1,961.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,287.33 / $2,203.76 / $3,574.47	Professional		$1,287.33	$2,203.76	$3,574.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,418.65 / $10,161.12 / $19,448.18	Facility		$7,418.65	$10,161.12	$19,448.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,237.70 / $1,967.20 / $3,302.66	Professional		$1,237.70	$1,967.20	$3,302.66
United Facility/Professional Facility Modifier Low / Median / High Price $1,403.00 / $2,428.00 / $11,941.00	Facility		$1,403.00	$2,428.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,803.90 / $2,300.48 / $4,187.63	Professional		$1,803.90	$2,300.48	$4,187.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $987.80 / $987.80 / $1,562.77	Professional		$987.80	$987.80	$1,562.77