Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $8,063.83 / $18,800.00	Facility		$1,733.00	$8,063.83	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $508.09 / $1,071.88 / $2,322.89	Professional		$508.09	$1,071.88	$2,322.89
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,409.85 / $10,166.93 / $19,448.18	Facility		$1,409.85	$10,166.93	$19,448.18
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,404.94 / $2,375.23 / $8,898.23	Professional		$1,404.94	$2,375.23	$8,898.23
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 $1,189.93 / $1,804.63 / $3,115.43	Professional		$1,189.93	$1,804.63	$3,115.43
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,371.05 / $2,314.69 / $4,240.71	Facility		$1,371.05	$2,314.69	$4,240.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,444.80 / $2,346.48 / $4,065.76	Professional		$1,444.80	$2,346.48	$4,065.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $106.93 / $478.49 / $2,029.71	Professional		$106.93	$478.49	$2,029.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,450.14 / $2,005.78 / $2,066.94	Facility		$1,450.14	$2,005.78	$2,066.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,313.10 / $1,409.85 / $1,961.22	Facility		$1,313.10	$1,409.85	$1,961.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,424.49 / $2,339.01 / $2,798.40	Professional		$1,424.49	$2,339.01	$2,798.40
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 $1,388.52 / $1,922.48 / $2,663.84	Professional		$1,388.52	$1,922.48	$2,663.84
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 $1,287.42 / $1,602.09 / $2,967.94	Professional		$1,287.42	$1,602.09	$2,967.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,104.36 / $1,104.36 / $1,104.36	Professional		$1,104.36	$1,104.36	$1,104.36