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 $1,104.65 / $1,485.16 / $3,290.17	Professional		$1,104.65	$1,485.16	$3,290.17
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $9,338.71 / $20,273.81 / $38,781.51	Facility		$9,338.71	$20,273.81	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,674.01 / $2,690.03 / $10,253.48	Professional		$1,674.01	$2,690.03	$10,253.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $10,540.05	Facility		$883.20	$1,075.31	$10,540.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,219.45 / $2,092.59 / $3,545.35	Professional		$1,219.45	$2,092.59	$3,545.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,255.09 / $2,562.98 / $9,243.26	Facility		$1,255.09	$2,562.98	$9,243.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,200.03 / $2,460.06 / $7,959.30	Professional		$1,200.03	$2,460.06	$7,959.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $118.54 / $697.92 / $2,267.95	Professional		$118.54	$697.92	$2,267.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,644.44 / $2,239.81 / $2,359.73	Facility		$1,644.44	$2,239.81	$2,359.73
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,568.74 / $1,609.55 / $9,338.71	Facility		$1,568.74	$1,609.55	$9,338.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,795.22 / $2,562.62 / $3,194.81	Professional		$1,795.22	$2,562.62	$3,194.81
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 $1,599.91 / $2,299.54 / $3,050.05	Professional		$1,599.91	$2,299.54	$3,050.05
United Facility/Professional Facility Modifier Low / Median / High Price $5,547.00 / $24,764.99 / $40,868.01	Facility		$5,547.00	$24,764.99	$40,868.01
United Facility/Professional Professional Modifier Low / Median / High Price $1,415.82 / $1,955.18 / $3,337.29	Professional		$1,415.82	$1,955.18	$3,337.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $979.77 / $979.77 / $1,261.66	Professional		$979.77	$979.77	$1,261.66