Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,213.85 / $5,128.00 / $18,800.00	Facility		$1,213.85	$5,128.00	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $755.47 / $1,213.85 / $2,392.11	Professional		$755.47	$1,213.85	$2,392.11
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 $1,316.98 / $2,249.73 / $8,586.90	Professional		$1,316.98	$2,249.73	$8,586.90
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 $1,056.56 / $1,599.94 / $2,994.06	Professional		$1,056.56	$1,599.94	$2,994.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,183.77 / $1,977.21 / $4,240.71	Facility		$1,183.77	$1,977.21	$4,240.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,183.77 / $1,977.21 / $4,065.76	Professional		$1,183.77	$1,977.21	$4,065.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.81 / $556.51 / $1,975.97	Professional		$78.81	$556.51	$1,975.97
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,324.47 / $1,794.26 / $1,984.54	Facility		$1,324.47	$1,794.26	$1,984.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,276.55 / $1,353.63 / $1,961.22	Facility		$1,276.55	$1,353.63	$1,961.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,353.63 / $2,162.48 / $2,686.83	Professional		$1,353.63	$2,162.48	$2,686.83
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 $1,286.70 / $1,777.39 / $2,456.83	Professional		$1,286.70	$1,777.39	$2,456.83
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 $1,147.02 / $1,399.53 / $2,743.30	Professional		$1,147.02	$1,399.53	$2,743.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,070.48 / $1,070.48 / $1,070.48	Professional		$1,070.48	$1,070.48	$1,070.48