Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,815.15 / $7,920.26 / $22,024.00	Facility		$1,815.15	$7,920.26	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,191.90 / $1,719.22 / $3,612.87	Professional		$1,191.90	$1,719.22	$3,612.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,781.20 / $15,555.67 / $31,745.76	Facility		$1,781.20	$15,555.67	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,869.84 / $2,911.69 / $12,480.69	Professional		$1,869.84	$2,911.69	$12,480.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $765.00 / $870.49 / $870.49	Facility		$765.00	$870.49	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,405.98 / $2,413.09 / $4,069.84	Professional		$1,405.98	$2,413.09	$4,069.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,305.72 / $2,676.72 / $4,120.31	Facility		$1,305.72	$2,676.72	$4,120.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,298.90 / $2,627.45 / $3,433.27	Professional		$1,298.90	$2,627.45	$3,433.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $156.75 / $760.79 / $2,663.50	Professional		$156.75	$760.79	$2,663.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,901.18 / $2,576.82 / $2,673.76	Facility		$1,901.18	$2,576.82	$2,673.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,771.02 / $1,781.20 / $5,317.93	Facility		$1,771.02	$1,781.20	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,043.90 / $2,909.68 / $3,605.72	Professional		$2,043.90	$2,909.68	$3,605.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,109.64 / $16,586.25 / $31,745.76	Facility		$12,109.64	$16,586.25	$31,745.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,816.58 / $2,610.59 / $3,445.20	Professional		$1,816.58	$2,610.59	$3,445.20
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 $1,581.07 / $2,148.09 / $3,840.75	Professional		$1,581.07	$2,148.09	$3,840.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,105.93 / $1,105.93 / $1,445.21	Professional		$1,105.93	$1,105.93	$1,445.21