Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,281.67 / $8,617.81 / $31,764.56	Facility		$2,281.67	$8,617.81	$31,764.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,133.08 / $1,584.58 / $3,361.11	Professional		$1,133.08	$1,584.58	$3,361.11
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,677.19 / $15,599.20 / $31,745.76	Facility		$1,677.19	$15,599.20	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,726.37 / $2,688.27 / $14,942.49	Professional		$1,726.37	$2,688.27	$14,942.49
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 $1,321.54 / $2,224.69 / $3,741.53	Professional		$1,321.54	$2,224.69	$3,741.53
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,314.32 / $2,705.12 / $5,194.27	Facility		$1,314.32	$2,705.12	$5,194.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,228.44 / $2,577.90 / $4,180.57	Professional		$1,228.44	$2,577.90	$4,180.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $673.31 / $2,424.81	Professional		$157.37	$673.31	$2,424.81
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,733.54 / $2,348.07 / $2,471.63	Facility		$1,733.54	$2,348.07	$2,471.63
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,644.39 / $1,644.39 / $1,677.19	Facility		$1,644.39	$1,644.39	$1,677.19
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,887.70 / $2,686.20 / $3,329.06	Professional		$1,887.70	$2,686.20	$3,329.06
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 $1,677.06 / $2,412.66 / $3,187.98	Professional		$1,677.06	$2,412.66	$3,187.98
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 $1,506.68 / $2,020.70 / $3,535.98	Professional		$1,506.68	$2,020.70	$3,535.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,022.00 / $1,022.00 / $1,329.91	Professional		$1,022.00	$1,022.00	$1,329.91