Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,906.36 / $5,132.00 / $22,024.00	Facility		$1,906.36	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,274.82 / $1,906.36 / $4,278.77	Professional		$1,274.82	$1,906.36	$4,278.77
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,067.92 / $18,220.34 / $35,644.43	Facility		$2,067.92	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,095.60 / $3,488.20 / $13,170.90	Professional		$2,095.60	$3,488.20	$13,170.90
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 $1,516.76 / $2,678.06 / $4,548.77	Professional		$1,516.76	$2,678.06	$4,548.77
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,350.05 / $2,504.12 / $4,171.43	Facility		$1,350.05	$2,504.12	$4,171.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,350.05 / $2,392.44 / $3,814.16	Professional		$1,350.05	$2,392.44	$3,814.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $893.18 / $2,939.59	Professional		$157.37	$893.18	$2,939.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,754.73 / $2,917.18 / $3,031.75	Facility		$1,754.73	$2,917.18	$3,031.75
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,017.66 / $2,017.66 / $2,067.92	Facility		$2,017.66	$2,017.66	$2,067.92
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,310.56 / $3,295.96 / $4,104.63	Professional		$2,310.56	$3,295.96	$4,104.63
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 $2,057.75 / $2,943.42 / $3,918.65	Professional		$2,057.75	$2,943.42	$3,918.65
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 $1,340.47 / $2,473.35 / $4,321.34	Professional		$1,340.47	$2,473.35	$4,321.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,259.70 / $1,259.70 / $1,615.70	Professional		$1,259.70	$1,259.70	$1,615.70