Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,768.98 / $5,128.00 / $21,917.86	Facility		$1,768.98	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,300.19 / $1,768.98 / $3,970.39	Professional		$1,300.19	$1,768.98	$3,970.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,821.15 / $16,227.47 / $31,745.76	Facility		$1,821.15	$16,227.47	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,903.63 / $3,075.75 / $11,366.03	Professional		$1,903.63	$3,075.75	$11,366.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $765.00 / $870.49 / $870.49	Facility		$765.00	$870.49	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,443.14 / $2,473.67 / $4,103.14	Professional		$1,443.14	$2,473.67	$4,103.14
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,367.72 / $2,749.62 / $4,161.56	Facility		$1,367.72	$2,749.62	$4,161.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,367.72 / $2,662.77 / $3,476.65	Professional		$1,367.72	$2,662.77	$3,476.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $765.55 / $2,650.33	Professional		$157.37	$765.55	$2,650.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,970.29 / $2,621.65 / $2,717.96	Facility		$1,970.29	$2,621.65	$2,717.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,792.97 / $1,792.97 / $1,821.15	Facility		$1,792.97	$1,792.97	$1,821.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,052.63 / $2,897.10 / $3,614.79	Professional		$2,052.63	$2,897.10	$3,614.79
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,676.54 / $16,595.73 / $31,745.76	Facility		$12,676.54	$16,595.73	$31,745.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,828.60 / $2,592.16 / $3,520.96	Professional		$1,828.60	$2,592.16	$3,520.96
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 $1,650.18 / $2,168.84 / $3,857.16	Professional		$1,650.18	$2,168.84	$3,857.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,106.48 / $1,106.48 / $1,453.54	Professional		$1,106.48	$1,106.48	$1,453.54