Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $4,500.00 / $22,124.20	Facility		$1,733.00	$4,500.00	$22,124.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $955.42 / $1,417.45 / $3,039.95	Professional		$955.42	$1,417.45	$3,039.95
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,494.39 / $16,227.47 / $31,745.76	Facility		$1,494.39	$16,227.47	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,538.21 / $2,380.73 / $10,050.27	Professional		$1,538.21	$2,380.73	$10,050.27
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 $1,132.98 / $2,011.15 / $3,327.92	Professional		$1,132.98	$2,011.15	$3,327.92
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,080.04 / $2,260.86 / $6,059.92	Facility		$1,080.04	$2,260.86	$6,059.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,080.04 / $2,211.59 / $5,218.14	Professional		$1,080.04	$2,211.59	$5,218.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $138.48 / $533.05 / $2,088.68	Professional		$138.48	$533.05	$2,088.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,463.75 / $2,091.07 / $2,201.84	Facility		$1,463.75	$2,091.07	$2,201.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,466.81 / $1,494.39 / $5,317.93	Facility		$1,466.81	$1,494.39	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,678.07 / $2,396.12 / $2,966.22	Professional		$1,678.07	$2,396.12	$2,966.22
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 $1,495.96 / $2,149.69 / $2,862.93	Professional		$1,495.96	$2,149.69	$2,862.93
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 $1,251.10 / $1,796.30 / $3,175.91	Professional		$1,251.10	$1,796.30	$3,175.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $909.09 / $909.09 / $1,180.75	Professional		$909.09	$909.09	$1,180.75