Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,556.72 / $2,710.76 / $22,024.00	Facility		$1,556.72	$2,710.76	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,035.58 / $1,556.72 / $3,221.14	Professional		$1,035.58	$1,556.72	$3,221.14
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,687.70 / $19,056.41 / $38,781.51	Facility		$1,687.70	$19,056.41	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,737.19 / $2,813.52 / $10,751.40	Professional		$1,737.19	$2,813.52	$10,751.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $765.00 / $870.49	Facility		$714.97	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,212.84 / $2,161.23 / $3,729.13	Professional		$1,212.84	$2,161.23	$3,729.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,102.43 / $2,323.41 / $6,397.05	Facility		$1,102.43	$2,323.41	$6,397.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,097.40 / $2,236.07 / $5,065.67	Professional		$1,097.40	$2,236.07	$5,065.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $156.04 / $715.07 / $2,381.78	Professional		$156.04	$715.07	$2,381.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,403.99 / $2,055.90 / $2,474.31	Facility		$1,403.99	$2,055.90	$2,474.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,653.00 / $1,653.00 / $1,687.70	Facility		$1,653.00	$1,653.00	$1,687.70
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,888.36 / $2,700.26 / $3,349.92	Professional		$1,888.36	$2,700.26	$3,349.92
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 $1,685.84 / $2,402.23 / $3,234.88	Professional		$1,685.84	$2,402.23	$3,234.88
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 $1,337.30 / $1,988.81 / $3,492.19	Professional		$1,337.30	$1,988.81	$3,492.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,023.66 / $1,023.66 / $1,329.21	Professional		$1,023.66	$1,023.66	$1,329.21