Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,453.66 / $7,859.45 / $22,024.00	Facility		$1,453.66	$7,859.45	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $801.78 / $3,404.26 / $8,099.23	Professional		$801.78	$3,404.26	$8,099.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $7,299.89 / $16,227.47 / $31,745.76	Facility		$7,299.89	$16,227.47	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,361.28 / $7,470.48 / $29,962.16	Professional		$1,361.28	$7,470.48	$29,962.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,394.89 / $1,698.13 / $9,132.70	Facility		$1,394.89	$1,698.13	$9,132.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,072.27 / $3,429.81 / $11,562.86	Professional		$1,072.27	$3,429.81	$11,562.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,120.90 / $4,619.42 / $10,174.75	Facility		$1,120.90	$4,619.42	$10,174.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,120.90 / $3,938.24 / $10,174.75	Professional		$1,120.90	$3,938.24	$10,174.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $458.54 / $2,330.95 / $8,027.42	Professional		$458.54	$2,330.95	$8,027.42
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,750.04 / $7,698.30 / $8,145.19	Facility		$1,750.04	$7,698.30	$8,145.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,526.69 / $5,555.75 / $7,587.08	Facility		$2,526.69	$5,555.75	$7,587.08
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,310.02 / $2,627.42 / $10,277.89	Professional		$1,310.02	$2,627.42	$10,277.89
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 $1,244.83 / $2,536.03 / $10,027.09	Professional		$1,244.83	$2,536.03	$10,027.09
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 $4,357.47 / $6,568.78 / $11,905.59	Professional		$4,357.47	$6,568.78	$11,905.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $866.63 / $3,307.02 / $4,643.21	Professional		$866.63	$3,307.02	$4,643.21