Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,571.95 / $5,132.00 / $22,024.00	Facility		$1,571.95	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $843.52 / $1,191.36 / $2,391.51	Professional		$843.52	$1,191.36	$2,391.51
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $9,294.85 / $20,273.81 / $38,781.51	Facility		$9,294.85	$20,273.81	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,212.35 / $2,004.50 / $7,494.83	Professional		$1,212.35	$2,004.50	$7,494.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,005.16 / $1,223.70 / $11,808.56	Facility		$1,005.16	$1,223.70	$11,808.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $881.71 / $1,532.70 / $2,598.39	Professional		$881.71	$1,532.70	$2,598.39
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $893.56 / $1,852.79 / $10,355.71	Facility		$893.56	$1,852.79	$10,355.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $826.02 / $1,755.22 / $8,917.20	Professional		$826.02	$1,755.22	$8,917.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $472.19 / $1,665.93	Professional		$78.68	$472.19	$1,665.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,189.23 / $1,626.76 / $1,725.25	Facility		$1,189.23	$1,626.76	$1,725.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,143.36 / $1,176.78 / $9,294.85	Facility		$1,143.36	$1,176.78	$9,294.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,312.25 / $1,872.03 / $2,335.78	Professional		$1,312.25	$1,872.03	$2,335.78
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 $1,166.08 / $1,674.99 / $2,247.52	Professional		$1,166.08	$1,674.99	$2,247.52
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $5,547.00 / $19,271.00	Facility		$3,028.00	$5,547.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,047.83 / $1,404.70 / $2,426.30	Professional		$1,047.83	$1,404.70	$2,426.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $716.68 / $716.68 / $928.92	Professional		$716.68	$716.68	$928.92