Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,277.73 / $2,870.88 / $17,930.00	Facility		$1,277.73	$2,870.88	$17,930.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $862.90 / $1,386.07 / $2,778.45	Professional		$862.90	$1,386.07	$2,778.45
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,961.22 / $10,166.93 / $19,848.13	Facility		$1,961.22	$10,166.93	$19,848.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,379.54 / $2,470.91 / $8,613.75	Professional		$1,379.54	$2,470.91	$8,613.75
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 $1,168.67 / $1,780.21 / $3,205.86	Professional		$1,168.67	$1,780.21	$3,205.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,315.24 / $2,099.03 / $3,286.76	Facility		$1,315.24	$2,099.03	$3,286.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,374.24 / $2,195.42 / $3,202.76	Professional		$1,374.24	$2,195.42	$3,202.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $110.12 / $578.69 / $2,208.58	Professional		$110.12	$578.69	$2,208.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,555.25 / $2,106.48 / $2,262.59	Facility		$1,555.25	$2,106.48	$2,262.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,313.10 / $1,543.29 / $1,961.22	Facility		$1,313.10	$1,543.29	$1,961.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,407.44 / $2,282.48 / $2,869.54	Professional		$1,407.44	$2,282.48	$2,869.54
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 $1,341.03 / $1,941.09 / $2,720.17	Professional		$1,341.03	$1,941.09	$2,720.17
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 $1,379.88 / $1,717.14 / $3,247.96	Professional		$1,379.88	$1,717.14	$3,247.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,079.58 / $1,079.58 / $1,227.96	Professional		$1,079.58	$1,079.58	$1,227.96