Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,933.02 / $5,132.00 / $22,024.00	Facility		$1,933.02	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,410.35 / $1,933.02 / $4,152.08	Professional		$1,410.35	$1,933.02	$4,152.08
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,078.89 / $14,791.76 / $28,937.08	Facility		$2,078.89	$14,791.76	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,139.85 / $3,310.84 / $15,972.78	Professional		$2,139.85	$3,310.84	$15,972.78
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 $1,596.66 / $2,725.09 / $4,589.67	Professional		$1,596.66	$2,725.09	$4,589.67
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,445.53 / $2,866.69 / $4,181.31	Facility		$1,445.53	$2,866.69	$4,181.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,445.53 / $2,801.08 / $3,837.21	Professional		$1,445.53	$2,801.08	$3,837.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $890.77 / $2,962.15	Professional		$157.37	$890.77	$2,962.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,067.69 / $2,803.44 / $3,047.83	Facility		$2,067.69	$2,803.44	$3,047.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,039.86 / $2,039.86 / $2,078.89	Facility		$2,039.86	$2,039.86	$2,078.89
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,333.67 / $3,332.22 / $4,126.39	Professional		$2,333.67	$3,332.22	$4,126.39
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,555.00 / $15,127.44 / $28,937.08	Facility		$11,555.00	$15,127.44	$28,937.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,080.39 / $2,959.04 / $3,942.03	Professional		$2,080.39	$2,959.04	$3,942.03
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 $1,771.67 / $2,475.19 / $4,385.31	Professional		$1,771.67	$2,475.19	$4,385.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,265.22 / $1,265.22 / $1,629.63	Professional		$1,265.22	$1,265.22	$1,629.63