Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,487.79 / $5,128.00 / $20,680.40	Facility		$1,487.79	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $895.49 / $1,487.79 / $2,844.84	Professional		$895.49	$1,487.79	$2,844.84
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 $1,580.50 / $2,745.61 / $10,066.73	Professional		$1,580.50	$2,745.61	$10,066.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $796.68 / $1,285.00 / $4,636.17	Facility		$796.68	$1,285.00	$4,636.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,232.22 / $1,877.26 / $3,513.04	Professional		$1,232.22	$1,877.26	$3,513.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,402.20 / $2,346.48 / $4,240.71	Facility		$1,402.20	$2,346.48	$4,240.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,408.70 / $2,346.48 / $4,065.76	Professional		$1,408.70	$2,346.48	$4,065.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $141.67 / $627.37 / $2,279.13	Professional		$141.67	$627.37	$2,279.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,535.38 / $2,123.23 / $2,326.91	Facility		$1,535.38	$2,123.23	$2,326.91
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,313.10 / $1,587.16 / $1,961.22	Facility		$1,313.10	$1,587.16	$1,961.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,588.58 / $2,633.47 / $3,150.36	Professional		$1,588.58	$2,633.47	$3,150.36
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 $1,562.03 / $2,134.16 / $2,981.85	Professional		$1,562.03	$2,134.16	$2,981.85
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 $1,379.00 / $1,810.20 / $3,341.61	Professional		$1,379.00	$1,810.20	$3,341.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,258.11 / $1,258.11 / $1,258.11	Professional		$1,258.11	$1,258.11	$1,258.11