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 $1,019.41 / $1,419.51 / $3,034.21	Professional		$1,019.41	$1,419.51	$3,034.21
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,590.82 / $18,220.34 / $35,644.43	Facility		$1,590.82	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,616.49 / $2,646.15 / $10,494.00	Professional		$1,616.49	$2,646.15	$10,494.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $765.00 / $870.49	Facility		$714.97	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,123.30 / $2,026.49 / $3,456.74	Professional		$1,123.30	$2,026.49	$3,456.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,012.40 / $2,000.42 / $3,092.71	Facility		$1,012.40	$2,000.42	$3,092.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,012.40 / $1,984.35 / $2,836.97	Professional		$1,012.40	$1,984.35	$2,836.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $140.25 / $629.04 / $2,230.98	Professional		$140.25	$629.04	$2,230.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,405.81 / $1,923.75 / $2,332.27	Facility		$1,405.81	$1,923.75	$2,332.27
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,528.88 / $1,528.88 / $1,590.82	Facility		$1,528.88	$1,528.88	$1,590.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,765.59 / $2,530.69 / $3,157.62	Professional		$1,765.59	$2,530.69	$3,157.62
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 $1,559.25 / $2,264.32 / $3,014.55	Professional		$1,559.25	$2,264.32	$3,014.55
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 $1,291.99 / $1,881.13 / $3,318.42	Professional		$1,291.99	$1,881.13	$3,318.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $967.34 / $967.34 / $1,233.59	Professional		$967.34	$967.34	$1,233.59