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 / $20,680.40	Facility		$1,733.00	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $958.85 / $1,237.60 / $2,627.46	Professional		$958.85	$1,237.60	$2,627.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $9,693.35 / $20,273.81 / $38,781.51	Facility		$9,693.35	$20,273.81	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,385.77 / $2,256.28 / $8,530.35	Professional		$1,385.77	$2,256.28	$8,530.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $10,540.05	Facility		$714.97	$870.49	$10,540.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,009.67 / $1,744.47 / $2,954.07	Professional		$1,009.67	$1,744.47	$2,954.07
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,054.42 / $2,121.41 / $9,243.26	Facility		$1,054.42	$2,121.41	$9,243.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,008.15 / $2,051.28 / $7,959.30	Professional		$1,008.15	$2,051.28	$7,959.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $608.04 / $1,919.55	Professional		$81.90	$608.04	$1,919.55
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,393.08 / $1,863.94 / $1,963.77	Facility		$1,393.08	$1,863.94	$1,963.77
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,305.08 / $1,339.47 / $9,693.35	Facility		$1,305.08	$1,339.47	$9,693.35
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,495.16 / $2,131.94 / $2,658.71	Professional		$1,495.16	$2,131.94	$2,658.71
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 $1,331.02 / $1,910.39 / $2,560.80	Professional		$1,331.02	$1,910.39	$2,560.80
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 $1,174.74 / $1,594.29 / $2,809.61	Professional		$1,174.74	$1,594.29	$2,809.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $815.51 / $815.51 / $1,053.48	Professional		$815.51	$815.51	$1,053.48