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 $1,040.14 / $1,429.27 / $3,112.86	Professional		$1,040.14	$1,429.27	$3,112.86
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,490.98 / $9,526.26 / $20,286.13	Facility		$5,490.98	$9,526.26	$20,286.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,617.48 / $2,610.96 / $9,872.33	Professional		$1,617.48	$2,610.96	$9,872.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $4,934.85	Facility		$883.20	$1,075.31	$4,934.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,173.02 / $2,016.12 / $3,413.08	Professional		$1,173.02	$2,016.12	$3,413.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,181.33 / $2,384.28 / $4,327.70	Facility		$1,181.33	$2,384.28	$4,327.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,087.32 / $2,294.80 / $3,747.94	Professional		$1,087.32	$2,294.80	$3,747.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.51 / $631.56 / $2,165.29	Professional		$116.51	$631.56	$2,165.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,585.64 / $2,124.82 / $2,271.96	Facility		$1,585.64	$2,124.82	$2,271.96
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,341.67 / $1,510.76 / $4,028.71	Facility		$1,341.67	$1,510.76	$4,028.71
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,729.96 / $2,467.90 / $3,075.98	Professional		$1,729.96	$2,467.90	$3,075.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,006.61 / $9,172.83 / $17,546.59	Facility		$7,006.61	$9,172.83	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,540.77 / $2,205.78 / $2,936.61	Professional		$1,540.77	$2,205.78	$2,936.61
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 $1,363.74 / $1,851.84 / $3,250.83	Professional		$1,363.74	$1,851.84	$3,250.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $943.05 / $943.05 / $1,213.98	Professional		$943.05	$943.05	$1,213.98