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 $1,219.96 / $1,495.26 / $3,431.71	Professional		$1,219.96	$1,495.26	$3,431.71
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,801.95 / $18,633.84 / $35,644.43	Facility		$1,801.95	$18,633.84	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,854.79 / $2,908.77 / $11,428.73	Professional		$1,854.79	$2,908.77	$11,428.73
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 $1,280.83 / $2,359.46 / $3,978.12	Professional		$1,280.83	$2,359.46	$3,978.12
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,186.75 / $2,419.71 / $3,356.34	Facility		$1,186.75	$2,419.71	$3,356.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,160.33 / $2,362.48 / $3,149.69	Professional		$1,160.33	$2,362.48	$3,149.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $797.86 / $2,582.63	Professional		$157.37	$797.86	$2,582.63
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,722.70 / $2,345.67 / $2,641.81	Facility		$1,722.70	$2,345.67	$2,641.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,760.81 / $1,760.81 / $1,801.95	Facility		$1,760.81	$1,760.81	$1,801.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,018.84 / $2,819.25 / $3,576.70	Professional		$2,018.84	$2,819.25	$3,576.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,233.34 / $18,633.84 / $35,644.43	Facility		$14,233.34	$18,633.84	$35,644.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,795.79 / $2,544.28 / $3,414.64	Professional		$1,795.79	$2,544.28	$3,414.64
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $5,547.00 / $19,271.00	Facility		$3,028.00	$5,547.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,510.59 / $2,037.54 / $3,794.43	Professional		$1,510.59	$2,037.54	$3,794.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,098.19 / $1,098.19 / $1,418.47	Professional		$1,098.19	$1,098.19	$1,418.47