Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,480.13 / $2,883.66 / $22,024.00	Facility		$1,480.13	$2,883.66	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,079.78 / $1,480.13 / $3,174.17	Professional		$1,079.78	$1,480.13	$3,174.17
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,608.18 / $18,220.34 / $35,644.43	Facility		$1,608.18	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,655.34 / $2,753.01 / $10,243.65	Professional		$1,655.34	$2,753.01	$10,243.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $765.00 / $870.49 / $870.49	Facility		$765.00	$870.49	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,169.98 / $2,090.82 / $3,538.47	Professional		$1,169.98	$2,090.82	$3,538.47
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,133.30 / $2,094.44 / $3,218.25	Facility		$1,133.30	$2,094.44	$3,218.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,122.99 / $2,081.62 / $2,957.59	Professional		$1,122.99	$2,081.62	$2,957.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $118.54 / $699.73 / $2,282.53	Professional		$118.54	$699.73	$2,282.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,558.99 / $2,116.16 / $2,357.73	Facility		$1,558.99	$2,116.16	$2,357.73
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,568.29 / $1,568.29 / $1,608.18	Facility		$1,568.29	$1,568.29	$1,608.18
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,795.73 / $2,561.88 / $3,192.08	Professional		$1,795.73	$2,561.88	$3,192.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,233.34 / $18,633.84 / $35,644.43	Facility		$14,233.34	$18,633.84	$35,644.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,599.44 / $2,289.04 / $3,047.45	Professional		$1,599.44	$2,289.04	$3,047.45
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 $1,405.67 / $1,926.03 / $3,374.43	Professional		$1,405.67	$1,926.03	$3,374.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $979.21 / $979.21 / $1,257.06	Professional		$979.21	$979.21	$1,257.06