Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,128.00 / $20,680.40	Facility		$1,733.00	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $938.82 / $1,439.26 / $2,728.35	Professional		$938.82	$1,439.26	$2,728.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6,013.44 / $19,913.50 / $38,781.51	Facility		$6,013.44	$19,913.50	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,450.30 / $2,312.38 / $8,838.45	Professional		$1,450.30	$2,312.38	$8,838.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $8,315.84	Facility		$714.97	$870.49	$8,315.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,009.18 / $1,839.65 / $3,119.97	Professional		$1,009.18	$1,839.65	$3,119.97
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,026.16 / $2,097.67 / $7,292.72	Facility		$1,026.16	$2,097.67	$7,292.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $939.63 / $2,005.35 / $6,279.70	Professional		$939.63	$2,005.35	$6,279.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.13 / $563.31 / $1,987.13	Professional		$116.13	$563.31	$1,987.13
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,339.66 / $1,839.15 / $2,034.12	Facility		$1,339.66	$1,839.15	$2,034.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,375.31 / $1,387.45 / $6,526.97	Facility		$1,375.31	$1,387.45	$6,526.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,561.13 / $2,246.64 / $2,753.96	Professional		$1,561.13	$2,246.64	$2,753.96
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 $1,402.63 / $1,974.86 / $2,674.32	Professional		$1,402.63	$1,974.86	$2,674.32
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 $1,201.20 / $1,582.27 / $2,934.15	Professional		$1,201.20	$1,582.27	$2,934.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $834.28 / $834.28 / $1,107.04	Professional		$834.28	$834.28	$1,107.04