Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,185.38 / $5,128.00 / $18,800.00	Facility		$1,185.38	$5,128.00	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $719.50 / $1,185.38 / $2,299.92	Professional		$719.50	$1,185.38	$2,299.92
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 $1,277.89 / $2,207.14 / $8,152.20	Professional		$1,277.89	$2,207.14	$8,152.20
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 $1,002.74 / $1,521.31 / $2,846.93	Professional		$1,002.74	$1,521.31	$2,846.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,134.67 / $1,895.20 / $4,240.71	Facility		$1,134.67	$1,895.20	$4,240.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,134.67 / $1,895.20 / $4,065.76	Professional		$1,134.67	$1,895.20	$4,065.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.04 / $472.63 / $1,876.91	Professional		$75.04	$472.63	$1,876.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,278.41 / $1,710.51 / $1,884.04	Facility		$1,278.41	$1,710.51	$1,884.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,253.00 / $1,285.08 / $1,961.22	Facility		$1,253.00	$1,285.08	$1,961.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,285.08 / $2,119.23 / $2,550.77	Professional		$1,285.08	$2,119.23	$2,550.77
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 $1,262.96 / $1,727.97 / $2,378.42	Professional		$1,262.96	$1,727.97	$2,378.42
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 $1,103.33 / $1,366.04 / $2,661.90	Professional		$1,103.33	$1,366.04	$2,661.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,021.27 / $1,021.27 / $1,021.27	Professional		$1,021.27	$1,021.27	$1,021.27