Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,792.14 / $3,574.88 / $22,024.00	Facility		$1,792.14	$3,574.88	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,272.13 / $1,792.14 / $3,766.93	Professional		$1,272.13	$1,792.14	$3,766.93
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,844.62 / $16,227.47 / $31,745.76	Facility		$1,844.62	$16,227.47	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,910.60 / $2,993.94 / $14,907.82	Professional		$1,910.60	$2,993.94	$14,907.82
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 $1,411.28 / $2,470.57 / $4,170.16	Professional		$1,411.28	$2,470.57	$4,170.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,361.85 / $2,886.18 / $6,059.92	Facility		$1,361.85	$2,886.18	$6,059.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,361.85 / $2,834.53 / $5,218.14	Professional		$1,361.85	$2,834.53	$5,218.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $156.75 / $798.14 / $2,676.85	Professional		$156.75	$798.14	$2,676.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,867.15 / $2,522.50 / $2,746.33	Facility		$1,867.15	$2,522.50	$2,746.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,771.02 / $1,844.62 / $5,317.93	Facility		$1,771.02	$1,844.62	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,106.58 / $2,979.97 / $3,718.20	Professional		$2,106.58	$2,979.97	$3,718.20
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 $1,881.26 / $2,694.68 / $3,601.12	Professional		$1,881.26	$2,694.68	$3,601.12
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 $1,563.89 / $2,215.09 / $3,969.89	Professional		$1,563.89	$2,215.09	$3,969.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,139.06 / $1,139.06 / $1,486.93	Professional		$1,139.06	$1,139.06	$1,486.93