Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,639.69 / $3,955.02 / $18,711.00	Facility		$1,639.69	$3,955.02	$18,711.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $819.85 / $1,579.21 / $1,807.26	Facility	52	$819.85	$1,579.21	$1,807.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,062.39 / $1,503.47 / $3,187.18	Professional		$1,062.39	$1,503.47	$3,187.18
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 Facility Modifier 52 Low / Median / High Price $5,061.26 / $8,418.48 / $8,418.48	Facility	52	$5,061.26	$8,418.48	$8,418.48
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $632.66 / $1,052.31 / $1,052.31	Facility	AS	$632.66	$1,052.31	$1,052.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,736.14 / $2,997.79 / $11,028.98	Professional		$1,736.14	$2,997.79	$11,028.98
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 $1,462.41 / $2,216.67 / $3,824.79	Professional		$1,462.41	$2,216.67	$3,824.79
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,654.22 / $2,504.83 / $3,854.06	Facility		$1,654.22	$2,504.83	$3,854.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,671.68 / $2,644.22 / $3,865.99	Professional		$1,671.68	$2,644.22	$3,865.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $141.92 / $711.25 / $2,467.72	Professional		$141.92	$711.25	$2,467.72
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,864.98 / $2,452.26 / $2,680.00	Facility		$1,864.98	$2,452.26	$2,680.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,313.10 / $1,736.14 / $1,961.22	Facility		$1,313.10	$1,736.14	$1,961.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,754.90 / $2,881.53 / $3,446.07	Professional		$1,754.90	$2,881.53	$3,446.07
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 $1,720.93 / $2,368.39 / $3,319.23	Professional		$1,720.93	$2,368.39	$3,319.23
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 $1,580.74 / $2,043.66 / $3,656.36	Professional		$1,580.74	$2,043.66	$3,656.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,351.98 / $1,351.98 / $1,351.98	Professional		$1,351.98	$1,351.98	$1,351.98