Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $4,011.00 / $18,711.00	Facility		$1,733.00	$4,011.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,034.97 / $1,499.12 / $3,240.88	Professional		$1,034.97	$1,499.12	$3,240.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,490.98 / $9,522.34 / $17,546.59	Facility		$5,490.98	$9,522.34	$17,546.59
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,725.76 / $2,682.98 / $11,141.48	Professional		$1,725.76	$2,682.98	$11,141.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $3,740.43	Facility		$625.25	$761.81	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,223.31 / $2,089.08 / $3,647.85	Professional		$1,223.31	$2,089.08	$3,647.85
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,152.31 / $2,340.69 / $3,423.75	Facility		$1,152.31	$2,340.69	$3,423.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,142.97 / $2,322.31 / $3,280.24	Professional		$1,142.97	$2,322.31	$3,280.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $138.94 / $642.00 / $2,401.40	Professional		$138.94	$642.00	$2,401.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,655.54 / $2,289.39 / $2,470.29	Facility		$1,655.54	$2,289.39	$2,470.29
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $986.25 / $1,623.55 / $2,961.46	Facility		$986.25	$1,623.55	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,754.11 / $2,610.76 / $3,344.48	Professional		$1,754.11	$2,610.76	$3,344.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,693.27 / $9,167.59 / $17,546.59	Facility		$6,693.27	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,655.81 / $2,365.58 / $3,188.33	Professional		$1,655.81	$2,365.58	$3,188.33
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,129.00 / $11,941.00	Facility		$2,155.00	$3,129.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,383.49 / $1,991.23 / $3,322.35	Professional		$1,383.49	$1,991.23	$3,322.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,023.93 / $1,023.93 / $1,294.95	Professional		$1,023.93	$1,023.93	$1,294.95