Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,187.89 / $2,280.38 / $22,024.00	Facility		$1,187.89	$2,280.38	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $852.54 / $1,187.89 / $2,529.76	Professional		$852.54	$1,187.89	$2,529.76
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,286.91 / $35,815.01 / $70,064.83	Facility		$1,286.91	$35,815.01	$70,064.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,324.65 / $2,127.48 / $8,197.35	Professional		$1,324.65	$2,127.48	$8,197.35
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 $932.10 / $1,675.12 / $2,836.34	Professional		$932.10	$1,675.12	$2,836.34
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $829.56 / $1,618.74 / $2,569.04	Facility		$829.56	$1,618.74	$2,569.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $829.56 / $1,575.75 / $2,356.21	Professional		$829.56	$1,575.75	$2,356.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $587.86 / $1,829.15	Professional		$81.90	$587.86	$1,829.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,116.29 / $1,548.80 / $1,886.72	Facility		$1,116.29	$1,548.80	$1,886.72
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,253.45 / $1,253.45 / $1,286.91	Facility		$1,253.45	$1,253.45	$1,286.91
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,436.58 / $2,047.58 / $2,554.39	Professional		$1,436.58	$2,047.58	$2,554.39
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 $1,278.34 / $1,831.75 / $2,438.66	Professional		$1,278.34	$1,831.75	$2,438.66
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 $1,050.26 / $1,481.14 / $2,666.06	Professional		$1,050.26	$1,481.14	$2,666.06
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $784.30 / $784.30 / $1,011.42	Professional		$784.30	$784.30	$1,011.42