Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $970.47 / $5,128.00 / $18,800.00	Facility		$970.47	$5,128.00	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $645.32 / $970.47 / $2,037.28	Professional		$645.32	$970.47	$2,037.28
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 $1,087.55 / $1,857.60 / $6,958.65	Professional		$1,087.55	$1,857.60	$6,958.65
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 $893.59 / $1,355.52 / $2,429.69	Professional		$893.59	$1,355.52	$2,429.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $983.10 / $1,587.02 / $2,604.02	Facility		$983.10	$1,587.02	$2,604.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $983.10 / $1,588.78 / $2,496.58	Professional		$983.10	$1,588.78	$2,496.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.96 / $373.69 / $1,610.39	Professional		$70.96	$373.69	$1,610.39
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,070.65 / $1,478.34 / $1,608.00	Facility		$1,070.65	$1,478.34	$1,608.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $988.38 / $1,096.80 / $1,241.82	Facility		$988.38	$1,096.80	$1,241.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,096.80 / $1,786.19 / $2,177.04	Professional		$1,096.80	$1,786.19	$2,177.04
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 $1,074.83 / $1,474.80 / $1,981.21	Professional		$1,074.83	$1,474.80	$1,981.21
United Facility/Professional Facility Modifier Low / Median / High Price $629.00 / $1,120.00 / $6,857.00	Facility		$629.00	$1,120.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $910.14 / $1,126.83 / $2,267.66	Professional		$910.14	$1,126.83	$2,267.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $872.68 / $872.68 / $872.68	Professional		$872.68	$872.68	$872.68