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 $1,032.81 / $1,440.26 / $2,957.18	Professional		$1,032.81	$1,440.26	$2,957.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $10,189.10 / $20,273.81 / $38,781.51	Facility		$10,189.10	$20,273.81	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,557.69 / $2,536.42 / $9,592.79	Professional		$1,557.69	$2,536.42	$9,592.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,005.16 / $1,223.70 / $10,539.33	Facility		$1,005.16	$1,223.70	$10,539.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,138.55 / $1,959.41 / $3,317.80	Professional		$1,138.55	$1,959.41	$3,317.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,148.43 / $2,393.09 / $9,242.64	Facility		$1,148.43	$2,393.09	$9,242.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,069.38 / $2,267.07 / $7,958.76	Professional		$1,069.38	$2,267.07	$7,958.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.51 / $631.56 / $2,128.24	Professional		$116.51	$631.56	$2,128.24
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,538.60 / $2,096.42 / $2,207.65	Facility		$1,538.60	$2,096.42	$2,207.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,467.27 / $1,505.82 / $10,189.10	Facility		$1,467.27	$1,505.82	$10,189.10
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,680.64 / $2,396.86 / $2,988.89	Professional		$1,680.64	$2,396.86	$2,988.89
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 $1,496.42 / $2,147.35 / $2,878.48	Professional		$1,496.42	$2,147.35	$2,878.48
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 $1,347.97 / $1,733.26 / $3,158.15	Professional		$1,347.97	$1,733.26	$3,158.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $916.54 / $916.54 / $1,181.24	Professional		$916.54	$916.54	$1,181.24