Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $4,011.00 / $18,711.00	Facility		$1,733.00	$4,011.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,141.32 / $1,608.42 / $3,598.11	Professional		$1,141.32	$1,608.42	$3,598.11
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,589.88 / $16,394.00 / $31,745.76	Facility		$5,589.88	$16,394.00	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,706.17 / $2,855.41 / $10,320.15	Professional		$1,706.17	$2,855.41	$10,320.15
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 $1,329.23 / $2,275.80 / $3,668.80	Professional		$1,329.23	$2,275.80	$3,668.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,380.80 / $2,776.48 / $6,059.92	Facility		$1,380.80	$2,776.48	$6,059.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,289.75 / $2,720.20 / $5,218.14	Professional		$1,289.75	$2,720.20	$5,218.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $117.55 / $691.37 / $2,386.57	Professional		$117.55	$691.37	$2,386.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,874.25 / $2,385.88 / $2,548.67	Facility		$1,874.25	$2,385.88	$2,548.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,655.25 / $1,672.93 / $5,317.93	Facility		$1,655.25	$1,672.93	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,862.53 / $2,636.25 / $3,285.52	Professional		$1,862.53	$2,636.25	$3,285.52
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 $1,706.17 / $2,381.10 / $3,207.28	Professional		$1,706.17	$2,381.10	$3,207.28
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 $1,531.20 / $1,993.75 / $3,528.00	Professional		$1,531.20	$1,993.75	$3,528.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,010.69 / $1,010.69 / $1,303.23	Professional		$1,010.69	$1,010.69	$1,303.23