Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,046.40 / $2,364.38 / $22,024.00	Facility		$1,046.40	$2,364.38	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $699.52 / $948.78 / $2,221.65	Professional		$699.52	$948.78	$2,221.65
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,674.24 / $16,227.47 / $31,745.76	Facility		$4,674.24	$16,227.47	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,078.31 / $1,679.83 / $5,937.36	Professional		$1,078.31	$1,679.83	$5,937.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $6,910.09	Facility		$625.25	$761.81	$6,910.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $817.42 / $1,415.76 / $2,239.67	Professional		$817.42	$1,415.76	$2,239.67
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $848.54 / $1,600.22 / $5,185.60	Facility		$848.54	$1,600.22	$5,185.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $837.37 / $1,548.13 / $3,037.51	Professional		$837.37	$1,548.13	$3,037.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.81 / $473.23 / $1,588.55	Professional		$78.81	$473.23	$1,588.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,093.95 / $1,584.55 / $1,719.89	Facility		$1,093.95	$1,584.55	$1,719.89
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,057.30 / $1,089.95 / $5,317.93	Facility		$1,057.30	$1,089.95	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,089.95 / $1,539.49 / $1,982.43	Professional		$1,089.95	$1,539.49	$1,982.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,761.59 / $16,586.25 / $31,745.76	Facility		$10,761.59	$16,586.25	$31,745.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $961.68 / $1,427.86 / $1,960.46	Professional		$961.68	$1,427.86	$1,960.46
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $4,016.00 / $16,315.00	Facility		$2,912.00	$4,016.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $969.65 / $1,315.71 / $2,341.35	Professional		$969.65	$1,315.71	$2,341.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $670.29 / $730.18 / $888.03	Professional		$670.29	$730.18	$888.03