Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,360.28 / $5,128.00 / $20,680.40	Facility		$1,360.28	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $681.65 / $940.96 / $2,053.85	Professional		$681.65	$940.96	$2,053.85
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,961.46 / $9,172.83 / $20,286.13	Facility		$2,961.46	$9,172.83	$20,286.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,053.81 / $1,679.31 / $6,482.63	Professional		$1,053.81	$1,679.31	$6,482.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $3,740.43	Facility		$714.97	$870.49	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $724.54 / $1,326.30 / $2,250.69	Professional		$724.54	$1,326.30	$2,250.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $692.54 / $1,431.10 / $3,280.24	Facility		$692.54	$1,431.10	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $692.54 / $1,397.45 / $2,824.57	Professional		$692.54	$1,397.45	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $399.90 / $1,502.30	Professional		$78.68	$399.90	$1,502.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,009.21 / $1,395.61 / $1,492.09	Facility		$1,009.21	$1,395.61	$1,492.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $986.25 / $987.54 / $2,961.46	Facility		$986.25	$987.54	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,133.96 / $1,619.03 / $2,020.11	Professional		$1,133.96	$1,619.03	$2,020.11
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 $1,007.16 / $1,448.62 / $1,928.58	Professional		$1,007.16	$1,448.62	$1,928.58
United Facility/Professional Facility Modifier Low / Median / High Price $2,225.00 / $4,785.00 / $16,315.00	Facility		$2,225.00	$4,785.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $837.68 / $1,213.84 / $2,130.86	Professional		$837.68	$1,213.84	$2,130.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $620.04 / $620.04 / $807.24	Professional		$620.04	$620.04	$807.24