Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,472.25 / $5,128.00 / $21,917.86	Facility		$1,472.25	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $805.31 / $1,022.83 / $2,490.79	Professional		$805.31	$1,022.83	$2,490.79
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $7,130.37 / $16,595.73 / $31,745.76	Facility		$7,130.37	$16,595.73	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,125.67 / $1,730.86 / $8,584.09	Professional		$1,125.67	$1,730.86	$8,584.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $8,822.09	Facility		$883.20	$1,075.31	$8,822.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $929.26 / $1,576.57 / $2,430.73	Professional		$929.26	$1,576.57	$2,430.73
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $977.88 / $1,935.69 / $7,736.68	Facility		$977.88	$1,935.69	$7,736.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $916.95 / $1,875.60 / $6,661.98	Professional		$916.95	$1,875.60	$6,661.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.79 / $471.42 / $1,576.48	Professional		$78.79	$471.42	$1,576.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,314.45 / $1,598.57 / $1,842.52	Facility		$1,314.45	$1,598.57	$1,842.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,059.57 / $1,093.59 / $7,130.37	Facility		$1,059.57	$1,093.59	$7,130.37
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,219.25 / $1,739.71 / $2,170.69	Professional		$1,219.25	$1,739.71	$2,170.69
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 $1,080.61 / $1,567.29 / $2,101.76	Professional		$1,080.61	$1,567.29	$2,101.76
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 $1,012.20 / $1,373.70 / $2,368.12	Professional		$1,012.20	$1,373.70	$2,368.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $674.98 / $674.98 / $874.79	Professional		$674.98	$674.98	$874.79