Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,623.10 / $10,700.00 / $22,024.00	Facility		$1,623.10	$10,700.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,003.67 / $1,623.10 / $1,749.60	Professional		$1,003.67	$1,623.10	$1,749.60
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 $1,704.24 / $2,974.36 / $11,075.48	Professional		$1,704.24	$2,974.36	$11,075.48
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 $1,447.88 / $2,188.00 / $3,822.27	Professional		$1,447.88	$2,188.00	$3,822.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,592.97 / $2,574.38 / $4,240.71	Facility		$1,592.97	$2,574.38	$4,240.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,592.97 / $2,628.36 / $4,065.76	Professional		$1,592.97	$2,628.36	$4,065.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $50.00 / $75.00	Professional		$45.00	$50.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,669.80 / $2,444.46 / $2,542.65	Facility		$1,669.80	$2,444.46	$2,542.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,313.10 / $1,734.32 / $1,961.22	Facility		$1,313.10	$1,734.32	$1,961.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,746.39 / $2,873.16 / $3,442.44	Professional		$1,746.39	$2,873.16	$3,442.44
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 $1,707.23 / $2,332.03 / $3,270.78	Professional		$1,707.23	$2,332.03	$3,270.78
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 $1,546.50 / $1,816.86 / $3,645.73	Professional		$1,546.50	$1,816.86	$3,645.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,203.34 / $1,203.34 / $1,203.34	Professional		$1,203.34	$1,203.34	$1,203.34