Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,879.17 / $11,093.00 / $27,982.24	Facility		$1,879.17	$11,093.00	$27,982.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $961.49 / $1,303.68 / $2,883.43	Professional		$961.49	$1,303.68	$2,883.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,385.17 / $16,227.47 / $31,745.76	Facility		$1,385.17	$16,227.47	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,425.78 / $2,220.21 / $13,778.46	Professional		$1,425.78	$2,220.21	$13,778.46
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 $1,077.22 / $1,887.09 / $3,075.46	Professional		$1,077.22	$1,887.09	$3,075.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,063.14 / $2,266.48 / $6,059.92	Facility		$1,063.14	$2,266.48	$6,059.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,039.15 / $2,174.37 / $5,218.14	Professional		$1,039.15	$2,174.37	$5,218.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $118.16 / $635.07 / $1,991.65	Professional		$118.16	$635.07	$1,991.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,465.79 / $1,998.55 / $2,037.96	Facility		$1,465.79	$1,998.55	$2,037.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,357.64 / $1,385.17 / $6,946.00	Facility		$1,357.64	$1,385.17	$6,946.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,557.33 / $2,217.78 / $2,749.42	Professional		$1,557.33	$2,217.78	$2,749.42
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 $1,384.61 / $1,992.58 / $2,640.06	Professional		$1,384.61	$1,992.58	$2,640.06
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 $1,225.08 / $1,667.05 / $2,926.43	Professional		$1,225.08	$1,667.05	$2,926.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $845.05 / $845.05 / $1,091.86	Professional		$845.05	$845.05	$1,091.86