Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,755.91 / $3,930.95 / $22,024.00	Facility		$1,755.91	$3,930.95	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,279.73 / $1,755.91 / $3,930.95	Professional		$1,279.73	$1,755.91	$3,930.95
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,905.23 / $35,815.01 / $70,064.83	Facility		$1,905.23	$35,815.01	$70,064.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,991.53 / $3,152.41 / $12,137.03	Professional		$1,991.53	$3,152.41	$12,137.03
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 $1,450.73 / $2,478.42 / $4,192.10	Professional		$1,450.73	$2,478.42	$4,192.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,319.98 / $2,675.52 / $3,818.14	Facility		$1,319.98	$2,675.52	$3,818.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,319.98 / $2,649.54 / $3,508.79	Professional		$1,319.98	$2,649.54	$3,508.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.08 / $805.84 / $2,664.05	Professional		$157.08	$805.84	$2,664.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,949.22 / $2,681.34 / $2,793.23	Facility		$1,949.22	$2,681.34	$2,793.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,858.66 / $1,858.66 / $1,905.23	Facility		$1,858.66	$1,858.66	$1,905.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,128.67 / $3,036.22 / $3,781.70	Professional		$2,128.67	$3,036.22	$3,781.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $27,977.90 / $36,627.79 / $70,064.83	Facility		$27,977.90	$36,627.79	$70,064.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,895.59 / $2,711.85 / $3,610.35	Professional		$1,895.59	$2,711.85	$3,610.35
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 $1,665.31 / $2,241.13 / $4,000.08	Professional		$1,665.31	$2,241.13	$4,000.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,160.04 / $1,160.04 / $1,489.14	Professional		$1,160.04	$1,160.04	$1,489.14