Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,825.21 / $5,116.62 / $21,917.86	Facility		$1,825.21	$5,116.62	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,347.48 / $1,825.21 / $4,186.85	Professional		$1,347.48	$1,825.21	$4,186.85
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,884.03 / $15,555.67 / $31,745.76	Facility		$1,884.03	$15,555.67	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,921.46 / $3,079.43 / $13,577.03	Professional		$1,921.46	$3,079.43	$13,577.03
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 $1,477.98 / $2,604.17 / $4,297.07	Professional		$1,477.98	$2,604.17	$4,297.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,399.36 / $2,876.12 / $4,349.06	Facility		$1,399.36	$2,876.12	$4,349.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,399.36 / $2,741.48 / $3,711.30	Professional		$1,399.36	$2,741.48	$3,711.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.08 / $782.52 / $2,775.22	Professional		$157.08	$782.52	$2,775.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,050.40 / $2,754.93 / $2,835.44	Facility		$2,050.40	$2,754.93	$2,835.44
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,771.02 / $1,884.03 / $5,317.93	Facility		$1,771.02	$1,884.03	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,160.53 / $3,077.66 / $3,813.45	Professional		$2,160.53	$3,077.66	$3,813.45
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 $1,921.46 / $2,734.62 / $3,661.02	Professional		$1,921.46	$2,734.62	$3,661.02
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 $1,715.48 / $2,271.84 / $4,059.94	Professional		$1,715.48	$2,271.84	$4,059.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,169.70 / $1,169.70 / $1,526.11	Professional		$1,169.70	$1,169.70	$1,526.11