Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,892.51 / $7,682.00 / $27,982.24	Facility		$1,892.51	$7,682.00	$27,982.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,029.83 / $1,377.56 / $3,252.18	Professional		$1,029.83	$1,377.56	$3,252.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,387.54 / $16,227.47 / $31,745.76	Facility		$1,387.54	$16,227.47	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,442.65 / $2,352.81 / $8,626.28	Professional		$1,442.65	$2,352.81	$8,626.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $6,910.09	Facility		$714.97	$870.49	$6,910.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,168.23 / $1,982.02 / $3,066.12	Professional		$1,168.23	$1,982.02	$3,066.12
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,236.70 / $2,463.57 / $6,059.92	Facility		$1,236.70	$2,463.57	$6,059.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,148.34 / $2,357.86 / $5,218.14	Professional		$1,148.34	$2,357.86	$5,218.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.51 / $576.78 / $1,963.58	Professional		$116.51	$576.78	$1,963.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,656.51 / $1,984.76 / $2,262.59	Facility		$1,656.51	$1,984.76	$2,262.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,380.14 / $1,387.54 / $5,317.93	Facility		$1,380.14	$1,387.54	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,570.17 / $2,245.09 / $2,748.30	Professional		$1,570.17	$2,245.09	$2,748.30
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 $1,415.11 / $1,985.35 / $2,712.56	Professional		$1,415.11	$1,985.35	$2,712.56
United Facility/Professional Facility Modifier Low / Median / High Price $1,547.00 / $2,408.00 / $10,522.00	Facility		$1,547.00	$2,408.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,274.39 / $1,752.29 / $3,100.31	Professional		$1,274.39	$1,752.29	$3,100.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $840.35 / $840.35 / $1,090.17	Professional		$840.35	$840.35	$1,090.17