Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,430.38 / $3,121.92 / $22,024.00	Facility		$1,430.38	$3,121.92	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,039.76 / $1,430.38 / $3,121.92	Professional		$1,039.76	$1,430.38	$3,121.92
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,551.06 / $35,815.01 / $70,064.83	Facility		$1,551.06	$35,815.01	$70,064.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,596.54 / $2,561.19 / $9,881.70	Professional		$1,596.54	$2,561.19	$9,881.70
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 $1,177.84 / $2,016.43 / $3,417.90	Professional		$1,177.84	$2,016.43	$3,417.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,074.46 / $2,176.98 / $3,107.96	Facility		$1,074.46	$2,176.98	$3,107.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,074.46 / $2,145.05 / $2,850.17	Professional		$1,074.46	$2,145.05	$2,850.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.28 / $631.56 / $2,229.65	Professional		$116.28	$631.56	$2,229.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,582.70 / $2,132.67 / $2,273.98	Facility		$1,582.70	$2,132.67	$2,273.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,508.49 / $1,508.49 / $1,551.06	Facility		$1,508.49	$1,508.49	$1,551.06
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,729.45 / $2,467.44 / $3,078.70	Professional		$1,729.45	$2,467.44	$3,078.70
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 $1,538.46 / $2,207.73 / $2,939.20	Professional		$1,538.46	$2,207.73	$2,939.20
United Facility/Professional Facility Modifier Low / Median / High Price $2,853.00 / $5,643.00 / $19,271.00	Facility		$2,853.00	$5,643.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,363.74 / $2,109.25 / $3,414.80	Professional		$1,363.74	$2,109.25	$3,414.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $944.71 / $944.71 / $1,218.20	Professional		$944.71	$944.71	$1,218.20