Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,763.86 / $5,116.62 / $21,283.57	Facility		$1,763.86	$5,116.62	$21,283.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,198.75 / $1,763.86 / $3,759.71	Professional		$1,198.75	$1,763.86	$3,759.71
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,828.76 / $15,555.67 / $31,745.76	Facility		$1,828.76	$15,555.67	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,918.76 / $2,987.87 / $13,111.43	Professional		$1,918.76	$2,987.87	$13,111.43
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 $1,455.38 / $2,575.29 / $4,172.17	Professional		$1,455.38	$2,575.29	$4,172.17
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,334.55 / $2,719.58 / $4,225.31	Facility		$1,334.55	$2,719.58	$4,225.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,334.55 / $2,643.94 / $3,527.98	Professional		$1,334.55	$2,643.94	$3,527.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.08 / $765.55 / $2,695.41	Professional		$157.08	$765.55	$2,695.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,006.72 / $2,687.26 / $2,786.53	Facility		$2,006.72	$2,687.26	$2,786.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,771.02 / $1,828.76 / $5,317.93	Facility		$1,771.02	$1,828.76	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,097.33 / $2,987.38 / $3,700.06	Professional		$2,097.33	$2,987.38	$3,700.06
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 $1,865.09 / $2,653.31 / $3,537.69	Professional		$1,865.09	$2,653.31	$3,537.69
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 $1,634.89 / $2,328.14 / $3,906.56	Professional		$1,634.89	$2,328.14	$3,906.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,134.91 / $1,134.91 / $1,481.63	Professional		$1,134.91	$1,134.91	$1,481.63