Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,610.24 / $5,128.00 / $20,680.40	Facility		$1,610.24	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $816.05 / $1,133.05 / $2,386.46	Professional		$816.05	$1,133.05	$2,386.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,358.00 / $16,547.20 / $31,745.76	Facility		$5,358.00	$16,547.20	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,216.45 / $1,878.56 / $7,988.04	Professional		$1,216.45	$1,878.56	$7,988.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $6,910.09	Facility		$714.97	$870.49	$6,910.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $911.44 / $1,570.03 / $2,666.45	Professional		$911.44	$1,570.03	$2,666.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $929.16 / $1,883.73 / $6,059.92	Facility		$929.16	$1,883.73	$6,059.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $871.27 / $1,859.10 / $5,218.14	Professional		$871.27	$1,859.10	$5,218.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.85 / $483.60 / $1,689.13	Professional		$78.85	$483.60	$1,689.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,192.17 / $1,620.42 / $1,737.40	Facility		$1,192.17	$1,620.42	$1,737.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,157.42 / $1,181.80 / $5,317.93	Facility		$1,157.42	$1,181.80	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,328.17 / $1,890.70 / $2,345.76	Professional		$1,328.17	$1,890.70	$2,345.76
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 $1,180.41 / $1,700.03 / $2,274.80	Professional		$1,180.41	$1,700.03	$2,274.80
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 $1,058.82 / $1,438.99 / $2,495.81	Professional		$1,058.82	$1,438.99	$2,495.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $718.88 / $718.88 / $945.92	Professional		$718.88	$718.88	$945.92