Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,128.79 / $5,128.00 / $18,800.00	Facility		$1,128.79	$5,128.00	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $695.84 / $1,128.79 / $2,211.96	Professional		$695.84	$1,128.79	$2,211.96
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,241.82 / $7,873.79 / $15,720.23	Facility		$1,241.82	$7,873.79	$15,720.23
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,196.58 / $2,068.50 / $7,651.20	Professional		$1,196.58	$2,068.50	$7,651.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $644.92 / $1,110.00 / $2,846.84	Facility		$644.92	$1,110.00	$2,846.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $986.41 / $1,495.68 / $2,669.81	Professional		$986.41	$1,495.68	$2,669.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,088.20 / $1,753.98 / $2,705.62	Facility		$1,088.20	$1,753.98	$2,705.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,088.20 / $1,799.73 / $2,705.62	Professional		$1,088.20	$1,799.73	$2,705.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $384.03 / $1,760.29	Professional		$71.55	$384.03	$1,760.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,209.81 / $1,644.18 / $1,768.13	Facility		$1,209.81	$1,644.18	$1,768.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $988.38 / $1,206.02 / $1,241.82	Facility		$988.38	$1,206.02	$1,241.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,206.50 / $1,998.12 / $2,393.84	Professional		$1,206.50	$1,998.12	$2,393.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,221.67 / $8,047.87 / $15,403.47	Facility		$5,221.67	$8,047.87	$15,403.47
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,182.58 / $1,621.67 / $2,261.27	Professional		$1,182.58	$1,621.67	$2,261.27
United Facility/Professional Facility Modifier Low / Median / High Price $862.03 / $2,136.00 / $10,522.00	Facility		$862.03	$2,136.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,059.66 / $1,311.96 / $2,535.41	Professional		$1,059.66	$1,311.96	$2,535.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $957.79 / $957.79 / $957.79	Professional		$957.79	$957.79	$957.79