Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,172.33 / $10,700.00 / $22,024.00	Facility		$1,172.33	$10,700.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $725.06 / $1,172.33 / $1,263.68	Professional		$725.06	$1,172.33	$1,263.68
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 $1,247.40 / $2,120.76 / $7,995.83	Professional		$1,247.40	$2,120.76	$7,995.83
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 $1,045.49 / $1,579.90 / $2,759.80	Professional		$1,045.49	$1,579.90	$2,759.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,150.14 / $1,916.90 / $4,240.71	Facility		$1,150.14	$1,916.90	$4,240.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,150.14 / $1,918.80 / $4,065.76	Professional		$1,150.14	$1,918.80	$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 $1,236.05 / $1,765.78 / $1,835.80	Facility		$1,236.05	$1,765.78	$1,835.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,223.09 / $1,252.18 / $1,961.22	Facility		$1,223.09	$1,252.18	$1,961.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,261.49 / $2,074.96 / $2,485.44	Professional		$1,261.49	$2,074.96	$2,485.44
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 $1,232.82 / $1,683.73 / $2,362.57	Professional		$1,232.82	$1,683.73	$2,362.57
United Facility/Professional Facility Modifier Low / Median / High Price $1,403.00 / $3,248.44 / $11,941.00	Facility		$1,403.00	$3,248.44	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,081.57 / $1,295.15 / $2,611.61	Professional		$1,081.57	$1,295.15	$2,611.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $834.10 / $834.10 / $834.10	Professional		$834.10	$834.10	$834.10