Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $991.81 / $2,150.46 / $22,024.00	Facility		$991.81	$2,150.46	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $719.74 / $991.81 / $2,150.46	Professional		$719.74	$991.81	$2,150.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,073.49 / $18,220.34 / $35,644.43	Facility		$1,073.49	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,104.97 / $1,797.92 / $6,837.68	Professional		$1,104.97	$1,797.92	$6,837.68
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 $808.23 / $1,397.36 / $2,369.16	Professional		$808.23	$1,397.36	$2,369.16
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $737.80 / $1,496.26 / $2,134.14	Facility		$737.80	$1,496.26	$2,134.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $737.80 / $1,492.95 / $1,954.71	Professional		$737.80	$1,492.95	$1,954.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $410.67 / $1,537.84	Professional		$78.68	$410.67	$1,537.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,082.90 / $1,463.27 / $1,573.83	Facility		$1,082.90	$1,463.27	$1,573.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,043.71 / $1,043.71 / $1,073.49	Facility		$1,043.71	$1,043.71	$1,073.49
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,196.64 / $1,707.72 / $2,130.78	Professional		$1,196.64	$1,707.72	$2,130.78
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 $1,064.45 / $1,527.98 / $2,034.23	Professional		$1,064.45	$1,527.98	$2,034.23
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 $939.12 / $1,280.94 / $2,342.96	Professional		$939.12	$1,280.94	$2,342.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $654.28 / $654.28 / $846.91	Professional		$654.28	$654.28	$846.91