Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,149.28 / $2,275.35 / $17,100.00	Facility		$1,149.28	$2,275.35	$17,100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $763.50 / $1,149.28 / $2,378.52	Professional		$763.50	$1,149.28	$2,378.52
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,897.78 / $9,172.83 / $17,546.59	Facility		$2,897.78	$9,172.83	$17,546.59
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,210.44 / $1,938.72 / $6,943.80	Professional		$1,210.44	$1,938.72	$6,943.80
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 $882.48 / $1,547.60 / $2,603.50	Professional		$882.48	$1,547.60	$2,603.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $838.40 / $1,633.92 / $2,824.57	Facility		$838.40	$1,633.92	$2,824.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $820.69 / $1,622.78 / $2,520.12	Professional		$820.69	$1,622.78	$2,520.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.13 / $532.91 / $1,786.18	Professional		$116.13	$532.91	$1,786.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,141.65 / $1,683.04 / $1,833.12	Facility		$1,141.65	$1,683.04	$1,833.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $986.25 / $1,186.85 / $2,961.46	Facility		$986.25	$1,186.85	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,250.34 / $1,806.65 / $2,256.23	Professional		$1,250.34	$1,806.65	$2,256.23
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,646.13 / $9,167.59 / $17,546.59	Facility		$5,646.13	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,145.90 / $1,658.02 / $2,224.01	Professional		$1,145.90	$1,658.02	$2,224.01
United Facility/Professional Facility Modifier Low / Median / High Price $702.00 / $1,436.00 / $6,857.00	Facility		$702.00	$1,436.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,063.44 / $1,456.98 / $2,543.40	Professional		$1,063.44	$1,456.98	$2,543.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $766.36 / $860.45 / $1,008.04	Professional		$766.36	$860.45	$1,008.04