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 $1,048.01 / $1,334.91 / $3,259.88	Professional		$1,048.01	$1,334.91	$3,259.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,425.84 / $16,227.47 / $31,745.76	Facility		$1,425.84	$16,227.47	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,457.18 / $2,285.84 / $10,228.59	Professional		$1,457.18	$2,285.84	$10,228.59
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 $1,090.63 / $1,968.27 / $3,193.60	Professional		$1,090.63	$1,968.27	$3,193.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,066.88 / $2,075.67 / $3,254.06	Facility		$1,066.88	$2,075.67	$3,254.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,033.54 / $1,925.36 / $2,764.52	Professional		$1,033.54	$1,925.36	$2,764.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.13 / $572.07 / $2,085.87	Professional		$116.13	$572.07	$2,085.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,586.74 / $2,039.35 / $2,194.25	Facility		$1,586.74	$2,039.35	$2,194.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,406.11 / $1,406.11 / $1,425.84	Facility		$1,406.11	$1,406.11	$1,425.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,606.65 / $2,296.96 / $2,830.15	Professional		$1,606.65	$2,296.96	$2,830.15
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 $1,434.05 / $2,029.50 / $2,701.92	Professional		$1,434.05	$2,029.50	$2,701.92
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 $1,220.93 / $1,656.98 / $3,019.11	Professional		$1,220.93	$1,656.98	$3,019.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $865.75 / $865.75 / $1,136.82	Professional		$865.75	$865.75	$1,136.82