Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,748.10 / $2,522.03 / $4,161.35	Facility		$1,748.10	$2,522.03	$4,161.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,106.40 / $1,748.10 / $4,161.35	Professional		$1,106.40	$1,748.10	$4,161.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,402.03 / $8,921.56 / $17,453.22	Facility		$1,402.03	$8,921.56	$17,453.22
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,738.18 / $2,764.62 / $10,200.08	Professional		$1,738.18	$2,764.62	$10,200.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $1,580.60	Facility		$714.97	$870.49	$1,580.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,391.71 / $2,254.42 / $3,802.16	Professional		$1,391.71	$2,254.42	$3,802.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,186.15 / $2,338.78 / $3,764.88	Facility		$1,186.15	$2,338.78	$3,764.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,186.15 / $2,316.84 / $3,532.01	Professional		$1,186.15	$2,316.84	$3,532.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $759.59 / $2,696.07	Professional		$157.37	$759.59	$2,696.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,741.00 / $2,602.96 / $3,008.42	Facility		$1,741.00	$2,602.96	$3,008.42
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $466.91 / $1,792.97 / $1,864.10	Facility		$466.91	$1,792.97	$1,864.10
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,713.58 / $2,434.76 / $3,357.34	Professional		$1,713.58	$2,434.76	$3,357.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,812.14 / $9,118.81 / $17,453.22	Facility		$6,812.14	$9,118.81	$17,453.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,488.21 / $2,285.07 / $3,274.95	Professional		$1,488.21	$2,285.07	$3,274.95
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 $1,724.41 / $2,215.40 / $3,892.44	Professional		$1,724.41	$2,215.40	$3,892.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,109.33 / $1,152.30 / $1,515.00	Professional		$1,109.33	$1,152.30	$1,515.00