Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,661.52 / $5,128.00 / $21,917.86	Facility		$1,661.52	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $909.49 / $1,228.82 / $2,423.41	Professional		$909.49	$1,228.82	$2,423.41
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6,013.44 / $20,273.81 / $38,781.51	Facility		$6,013.44	$20,273.81	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,342.68 / $2,141.86 / $8,082.98	Professional		$1,342.68	$2,141.86	$8,082.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $10,588.10	Facility		$883.20	$1,075.31	$10,588.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $917.49 / $1,686.83 / $2,860.84	Professional		$917.49	$1,686.83	$2,860.84
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $940.47 / $1,922.43 / $8,400.23	Facility		$940.47	$1,922.43	$8,400.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $855.78 / $1,821.20 / $7,995.59	Professional		$855.78	$1,821.20	$7,995.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.13 / $549.94 / $1,793.16	Professional		$116.13	$549.94	$1,793.16
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,216.18 / $1,675.00 / $1,860.59	Facility		$1,216.18	$1,675.00	$1,860.59
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,258.89 / $1,269.08 / $6,526.97	Facility		$1,258.89	$1,269.08	$6,526.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,429.11 / $2,056.46 / $2,519.02	Professional		$1,429.11	$2,056.46	$2,519.02
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 $1,283.90 / $1,806.38 / $2,448.16	Professional		$1,283.90	$1,806.38	$2,448.16
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,129.00 / $11,941.00	Facility		$2,155.00	$3,129.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,104.18 / $1,492.92 / $2,686.02	Professional		$1,104.18	$1,492.92	$2,686.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $763.05 / $763.05 / $1,017.32	Professional		$763.05	$763.05	$1,017.32