Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,585.19 / $5,128.00 / $20,680.40	Facility		$1,585.19	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $818.57 / $1,153.52 / $2,312.07	Professional		$818.57	$1,153.52	$2,312.07
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 $1,245.15 / $2,017.15 / $7,704.15	Professional		$1,245.15	$2,017.15	$7,704.15
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 $867.02 / $1,604.33 / $2,711.33	Professional		$867.02	$1,604.33	$2,711.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $870.87 / $1,767.79 / $3,280.24	Facility		$870.87	$1,767.79	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $798.83 / $1,684.71 / $2,824.57	Professional		$798.83	$1,684.71	$2,824.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.13 / $481.46 / $1,692.11	Professional		$116.13	$481.46	$1,692.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,151.01 / $1,557.75 / $1,773.49	Facility		$1,151.01	$1,557.75	$1,773.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $986.25 / $1,195.01 / $2,961.46	Facility		$986.25	$1,195.01	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,361.82 / $1,952.12 / $2,401.09	Professional		$1,361.82	$1,952.12	$2,401.09
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,948.17 / $9,167.59 / $17,546.59	Facility		$5,948.17	$9,167.59	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,218.76 / $1,721.82 / $2,292.30	Professional		$1,218.76	$1,721.82	$2,292.30
United Facility/Professional Facility Modifier Low / Median / High Price $1,547.00 / $2,408.00 / $10,522.00	Facility		$1,547.00	$2,408.00	$10,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,016.02 / $1,430.44 / $2,518.44	Professional		$1,016.02	$1,430.44	$2,518.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $729.92 / $729.92 / $968.46	Professional		$729.92	$729.92	$968.46