Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,132.00 / $22,024.00	Facility		$1,733.00	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $961.62 / $1,342.42 / $2,930.75	Professional		$961.62	$1,342.42	$2,930.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6,526.97 / $19,913.50 / $38,781.51	Facility		$6,526.97	$19,913.50	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,481.45 / $2,414.00 / $9,056.85	Professional		$1,481.45	$2,414.00	$9,056.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,005.16 / $1,223.70 / $8,315.84	Facility		$1,005.16	$1,223.70	$8,315.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,085.15 / $1,862.20 / $3,151.93	Professional		$1,085.15	$1,862.20	$3,151.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,096.38 / $2,254.54 / $7,292.72	Facility		$1,096.38	$2,254.54	$7,292.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,003.08 / $2,144.55 / $6,279.70	Professional		$1,003.08	$2,144.55	$6,279.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.90 / $614.49 / $2,037.49	Professional		$81.90	$614.49	$2,037.49
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,452.85 / $1,988.56 / $2,092.41	Facility		$1,452.85	$1,988.56	$2,092.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,388.90 / $1,427.21 / $6,526.97	Facility		$1,388.90	$1,427.21	$6,526.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,594.32 / $2,270.42 / $2,832.87	Professional		$1,594.32	$2,270.42	$2,832.87
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,146.66 / $20,262.22 / $38,781.51	Facility		$13,146.66	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,416.49 / $2,032.54 / $2,730.64	Professional		$1,416.49	$2,032.54	$2,730.64
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 $1,254.54 / $1,702.59 / $2,995.95	Professional		$1,254.54	$1,702.59	$2,995.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $870.16 / $870.16 / $1,124.84	Professional		$870.16	$870.16	$1,124.84