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 $1,079.57 / $1,400.89 / $3,480.18	Professional		$1,079.57	$1,400.89	$3,480.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,771.02 / $14,082.76 / $28,937.08	Facility		$1,771.02	$14,082.76	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,541.03 / $2,499.34 / $9,431.03	Professional		$1,541.03	$2,499.34	$9,431.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $765.00 / $870.49	Facility		$714.97	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,164.83 / $2,066.28 / $3,331.04	Professional		$1,164.83	$2,066.28	$3,331.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,137.70 / $2,149.07 / $3,131.24	Facility		$1,137.70	$2,149.07	$3,131.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,137.70 / $2,055.83 / $3,008.29	Professional		$1,137.70	$2,055.83	$3,008.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.13 / $588.74 / $2,116.25	Professional		$116.13	$588.74	$2,116.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,662.08 / $2,133.36 / $2,343.66	Facility		$1,662.08	$2,133.36	$2,343.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,465.46 / $1,497.13 / $5,317.93	Facility		$1,465.46	$1,497.13	$5,317.93
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,680.64 / $2,393.90 / $2,971.66	Professional		$1,680.64	$2,393.90	$2,971.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,038.25 / $15,127.44 / $28,937.08	Facility		$11,038.25	$15,127.44	$28,937.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,494.57 / $2,130.96 / $2,837.02	Professional		$1,494.57	$2,130.96	$2,837.02
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 $1,320.10 / $1,770.35 / $3,039.30	Professional		$1,320.10	$1,770.35	$3,039.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $905.78 / $905.78 / $1,188.21	Professional		$905.78	$905.78	$1,188.21