Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,128.00 / $21,917.86	Facility		$1,733.00	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,093.45 / $1,437.35 / $3,202.77	Professional		$1,093.45	$1,437.35	$3,202.77
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6,400.95 / $20,273.81 / $38,781.51	Facility		$6,400.95	$20,273.81	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,621.32 / $2,606.88 / $9,928.50	Professional		$1,621.32	$2,606.88	$9,928.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $10,641.21	Facility		$883.20	$1,075.31	$10,641.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,180.07 / $2,027.45 / $3,431.88	Professional		$1,180.07	$2,027.45	$3,431.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,220.43 / $2,480.33 / $9,273.01	Facility		$1,220.43	$2,480.33	$9,273.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,166.88 / $2,392.10 / $8,035.68	Professional		$1,166.88	$2,392.10	$8,035.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.51 / $631.16 / $2,182.90	Professional		$116.51	$631.16	$2,182.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,593.97 / $2,160.75 / $2,284.69	Facility		$1,593.97	$2,160.75	$2,284.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,519.36 / $1,558.37 / $8,586.83	Facility		$1,519.36	$1,558.37	$8,586.83
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,739.73 / $2,481.96 / $3,093.21	Professional		$1,739.73	$2,481.96	$3,093.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,546.63 / $20,262.22 / $38,781.51	Facility		$12,546.63	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,549.55 / $2,226.11 / $2,953.06	Professional		$1,549.55	$2,226.11	$2,953.06
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $4,016.00 / $16,315.00	Facility		$2,912.00	$4,016.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,371.31 / $1,821.68 / $3,269.18	Professional		$1,371.31	$1,821.68	$3,269.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $948.57 / $948.57 / $1,220.88	Professional		$948.57	$948.57	$1,220.88