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 / $21,917.86	Facility		$1,733.00	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,102.40 / $1,540.95 / $3,199.98	Professional		$1,102.40	$1,540.95	$3,199.98
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,781.60 / $9,172.83 / $20,286.13	Facility		$4,781.60	$9,172.83	$20,286.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,679.33 / $2,735.00 / $10,391.18	Professional		$1,679.33	$2,735.00	$10,391.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $3,740.43	Facility		$883.20	$1,075.31	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,183.08 / $2,151.71 / $3,641.46	Professional		$1,183.08	$2,151.71	$3,641.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,212.23 / $2,351.90 / $3,709.68	Facility		$1,212.23	$2,351.90	$3,709.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,094.83 / $2,280.53 / $3,280.24	Professional		$1,094.83	$2,280.53	$3,280.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.95 / $710.59 / $2,333.53	Professional		$116.95	$710.59	$2,333.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,590.05 / $2,155.39 / $2,391.90	Facility		$1,590.05	$2,155.39	$2,391.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $986.25 / $1,611.32 / $2,961.46	Facility		$986.25	$1,611.32	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,833.40 / $2,632.18 / $3,238.35	Professional		$1,833.40	$2,632.18	$3,238.35
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 $1,643.33 / $2,322.21 / $3,091.62	Professional		$1,643.33	$2,322.21	$3,091.62
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 $1,364.16 / $1,863.11 / $3,445.86	Professional		$1,364.16	$1,863.11	$3,445.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $985.29 / $985.29 / $1,292.64	Professional		$985.29	$985.29	$1,292.64