Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,504.68 / $5,132.00 / $22,024.00	Facility		$1,504.68	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $756.06 / $1,039.63 / $2,288.03	Professional		$756.06	$1,039.63	$2,288.03
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $11,500.00 / $52,812.50 / $101,024.36	Facility		$11,500.00	$52,812.50	$101,024.36
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,157.55 / $1,883.00 / $7,132.95	Professional		$1,157.55	$1,883.00	$7,132.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $765.00 / $1,223.70 / $34,997.94	Facility		$765.00	$1,223.70	$34,997.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $829.66 / $1,467.10 / $2,485.13	Professional		$829.66	$1,467.10	$2,485.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $835.80 / $1,748.06 / $30,692.04	Facility		$835.80	$1,748.06	$30,692.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $777.35 / $1,671.11 / $26,428.63	Professional		$777.35	$1,671.11	$26,428.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.54 / $422.10 / $1,627.87	Professional		$78.54	$422.10	$1,627.87
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,120.65 / $1,549.71 / $1,646.86	Facility		$1,120.65	$1,549.71	$1,646.86
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,090.36 / $1,123.31 / $28,392.17	Facility		$1,090.36	$1,123.31	$28,392.17
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,253.67 / $1,786.97 / $2,229.65	Professional		$1,253.67	$1,786.97	$2,229.65
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $38,536.44 / $52,812.50 / $101,024.36	Facility		$38,536.44	$52,812.50	$101,024.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,112.03 / $1,598.88 / $2,147.19	Professional		$1,112.03	$1,598.88	$2,147.19
United Facility/Professional Facility Modifier Low / Median / High Price $3,700.00 / $7,614.00 / $24,236.00	Facility		$3,700.00	$7,614.00	$24,236.00
United Facility/Professional Professional Modifier Low / Median / High Price $977.76 / $1,326.96 / $2,355.83	Professional		$977.76	$1,326.96	$2,355.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $686.30 / $686.30 / $892.57	Professional		$686.30	$686.30	$892.57