Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,762.48 / $5,132.00 / $22,024.00	Facility		$1,762.48	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,399.80 / $1,762.48 / $3,963.60	Professional		$1,399.80	$1,762.48	$3,963.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,912.09 / $14,219.07 / $28,937.08	Facility		$1,912.09	$14,219.07	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,976.26 / $3,255.21 / $12,021.08	Professional		$1,976.26	$3,255.21	$12,021.08
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 $1,485.18 / $2,604.46 / $4,233.14	Professional		$1,485.18	$2,604.46	$4,233.14
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,412.36 / $2,752.24 / $3,887.17	Facility		$1,412.36	$2,752.24	$3,887.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,412.36 / $2,632.83 / $3,734.55	Professional		$1,412.36	$2,632.83	$3,734.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $865.19 / $2,721.64	Professional		$157.37	$865.19	$2,721.64
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,974.32 / $2,682.01 / $2,817.24	Facility		$1,974.32	$2,682.01	$2,817.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,876.78 / $1,876.78 / $1,912.09	Facility		$1,876.78	$1,876.78	$1,912.09
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,149.73 / $3,065.82 / $3,795.31	Professional		$2,149.73	$3,065.82	$3,795.31
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 $1,914.07 / $2,721.61 / $3,623.34	Professional		$1,914.07	$2,721.61	$3,623.34
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 $1,731.09 / $2,272.11 / $3,974.80	Professional		$1,731.09	$2,272.11	$3,974.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,157.55 / $1,157.55 / $1,494.26	Professional		$1,157.55	$1,157.55	$1,494.26