Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,132.00 / $22,024.00	Facility		$1,733.00	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $955.06 / $1,305.27 / $2,954.48	Professional		$955.06	$1,305.27	$2,954.48
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $8,113.00 / $16,547.20 / $31,745.76	Facility		$8,113.00	$16,547.20	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,420.08 / $2,205.94 / $11,315.02	Professional		$1,420.08	$2,205.94	$11,315.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,005.16 / $1,223.70 / $6,910.09	Facility		$1,005.16	$1,223.70	$6,910.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,047.48 / $1,842.19 / $3,102.76	Professional		$1,047.48	$1,842.19	$3,102.76
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,076.91 / $2,210.32 / $6,059.92	Facility		$1,076.91	$2,210.32	$6,059.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,004.50 / $2,153.17 / $5,218.14	Professional		$1,004.50	$2,153.17	$5,218.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.21 / $576.05 / $1,980.98	Professional		$80.21	$576.05	$1,980.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,451.87 / $1,956.40 / $2,026.75	Facility		$1,451.87	$1,956.40	$2,026.75
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,350.39 / $1,382.43 / $5,317.93	Facility		$1,350.39	$1,382.43	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,552.70 / $2,205.94 / $2,743.98	Professional		$1,552.70	$2,205.94	$2,743.98
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 $1,377.22 / $1,979.14 / $2,659.36	Professional		$1,377.22	$1,979.14	$2,659.36
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 $1,208.33 / $1,634.71 / $2,890.81	Professional		$1,208.33	$1,634.71	$2,890.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $842.01 / $842.01 / $1,102.63	Professional		$842.01	$842.01	$1,102.63