Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $6,470.00 / $24,827.00	Facility		$1,733.00	$6,470.00	$24,827.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,044.76 / $1,438.54 / $3,231.96	Professional		$1,044.76	$1,438.54	$3,231.96
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6,526.97 / $19,913.50 / $38,781.51	Facility		$6,526.97	$19,913.50	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,620.53 / $2,649.17 / $10,030.28	Professional		$1,620.53	$2,649.17	$10,030.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,394.89 / $1,698.13 / $8,315.84	Facility		$1,394.89	$1,698.13	$8,315.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,192.16 / $2,044.54 / $3,468.51	Professional		$1,192.16	$2,044.54	$3,468.51
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,200.82 / $2,491.81 / $7,292.72	Facility		$1,200.82	$2,491.81	$7,292.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,116.96 / $2,360.60 / $6,279.70	Professional		$1,116.96	$2,360.60	$6,279.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $118.16 / $692.49 / $2,209.00	Professional		$118.16	$692.49	$2,209.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,609.16 / $2,202.96 / $2,308.15	Facility		$1,609.16	$2,202.96	$2,308.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,528.42 / $1,574.37 / $6,526.97	Facility		$1,528.42	$1,574.37	$6,526.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,754.11 / $2,504.52 / $3,124.96	Professional		$1,754.11	$2,504.52	$3,124.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,793.48 / $20,262.22 / $38,781.51	Facility		$14,793.48	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,558.79 / $2,240.90 / $3,004.32	Professional		$1,558.79	$2,240.90	$3,004.32
United Facility/Professional Facility Modifier Low / Median / High Price $4,016.00 / $24,764.99 / $40,868.01	Facility		$4,016.00	$24,764.99	$40,868.01
United Facility/Professional Professional Modifier Low / Median / High Price $1,376.10 / $1,814.45 / $3,260.26	Professional		$1,376.10	$1,814.45	$3,260.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $954.92 / $954.92 / $1,228.93	Professional		$954.92	$954.92	$1,228.93