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 $1,079.99 / $1,367.78 / $3,421.72	Professional		$1,079.99	$1,367.78	$3,421.72
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,505.36 / $14,791.76 / $28,937.08	Facility		$1,505.36	$14,791.76	$28,937.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,547.22 / $2,379.27 / $10,299.59	Professional		$1,547.22	$2,379.27	$10,299.59
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 $1,156.97 / $2,064.42 / $3,328.05	Professional		$1,156.97	$2,064.42	$3,328.05
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,123.58 / $2,146.25 / $2,991.31	Facility		$1,123.58	$2,146.25	$2,991.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,086.85 / $2,053.14 / $2,889.90	Professional		$1,086.85	$2,053.14	$2,889.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $119.33 / $685.96 / $2,153.15	Professional		$119.33	$685.96	$2,153.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,677.34 / $2,137.48 / $2,274.81	Facility		$1,677.34	$2,137.48	$2,274.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,465.91 / $1,465.91 / $1,505.36	Facility		$1,465.91	$1,465.91	$1,505.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,685.26 / $2,394.73 / $2,987.99	Professional		$1,685.26	$2,394.73	$2,987.99
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $11,555.00 / $15,127.44 / $28,937.08	Facility		$11,555.00	$15,127.44	$28,937.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,495.03 / $2,142.67 / $2,852.60	Professional		$1,495.03	$2,142.67	$2,852.60
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 $1,336.01 / $1,802.05 / $3,166.84	Professional		$1,336.01	$1,802.05	$3,166.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $910.47 / $910.47 / $1,171.38	Professional		$910.47	$910.47	$1,171.38