Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,668.60 / $5,128.00 / $20,680.40	Facility		$1,668.60	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $785.56 / $1,224.92 / $2,433.73	Professional		$785.56	$1,224.92	$2,433.73
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 $1,314.77 / $2,129.00 / $8,137.35	Professional		$1,314.77	$2,129.00	$8,137.35
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 $918.34 / $1,693.97 / $2,869.80	Professional		$918.34	$1,693.97	$2,869.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $844.36 / $1,708.71 / $3,280.24	Facility		$844.36	$1,708.71	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $844.36 / $1,677.47 / $2,942.22	Professional		$844.36	$1,677.47	$2,942.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.13 / $500.20 / $1,854.47	Professional		$116.13	$500.20	$1,854.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,185.08 / $1,678.35 / $1,872.65	Facility		$1,185.08	$1,678.35	$1,872.65
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $986.25 / $1,264.78 / $2,961.46	Facility		$986.25	$1,264.78	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,437.33 / $2,066.08 / $2,535.34	Professional		$1,437.33	$2,066.08	$2,535.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,013.44 / $9,167.59 / $17,546.59	Facility		$6,013.44	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,289.90 / $1,818.09 / $2,422.48	Professional		$1,289.90	$1,818.09	$2,422.48
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 $980.01 / $1,495.82 / $2,701.46	Professional		$980.01	$1,495.82	$2,701.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $768.85 / $768.85 / $1,021.04	Professional		$768.85	$768.85	$1,021.04