Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,491.78 / $8,617.81 / $22,024.00	Facility		$2,491.78	$8,617.81	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,265.66 / $1,770.57 / $3,779.19	Professional		$1,265.66	$1,770.57	$3,779.19
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,825.26 / $16,586.25 / $31,745.76	Facility		$1,825.26	$16,586.25	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,867.86 / $2,919.68 / $14,575.95	Professional		$1,867.86	$2,919.68	$14,575.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $9,260.28	Facility		$714.97	$870.49	$9,260.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,435.96 / $2,492.55 / $4,098.81	Professional		$1,435.96	$2,492.55	$4,098.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,439.91 / $2,948.23 / $8,120.96	Facility		$1,439.91	$2,948.23	$8,120.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,376.09 / $2,897.76 / $6,992.89	Professional		$1,376.09	$2,897.76	$6,992.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.08 / $753.73 / $2,620.00	Professional		$157.08	$753.73	$2,620.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,862.93 / $2,549.35 / $2,700.28	Facility		$1,862.93	$2,549.35	$2,700.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,798.86 / $1,825.26 / $6,923.23	Facility		$1,798.86	$1,825.26	$6,923.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,057.77 / $2,903.64 / $3,622.96	Professional		$2,057.77	$2,903.64	$3,622.96
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 $1,834.60 / $2,598.02 / $3,533.29	Professional		$1,834.60	$2,598.02	$3,533.29
United Facility/Professional Facility Modifier Low / Median / High Price $2,225.00 / $4,785.00 / $16,315.00	Facility		$2,225.00	$4,785.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,660.68 / $2,214.23 / $3,866.82	Professional		$1,660.68	$2,214.23	$3,866.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,108.69 / $1,108.69 / $1,451.86	Professional		$1,108.69	$1,108.69	$1,451.86