Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,132.00 / $22,024.00	Facility		$1,733.00	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $960.76 / $1,321.40 / $2,902.60	Professional		$960.76	$1,321.40	$2,902.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6,526.97 / $20,273.81 / $38,781.51	Facility		$6,526.97	$20,273.81	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,474.23 / $2,444.61 / $9,122.54	Professional		$1,474.23	$2,444.61	$9,122.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,005.16 / $1,223.70 / $11,807.83	Facility		$1,005.16	$1,223.70	$11,807.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,080.83 / $1,864.41 / $3,158.69	Professional		$1,080.83	$1,864.41	$3,158.69
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,092.69 / $2,225.34 / $9,367.92	Facility		$1,092.69	$2,225.34	$9,367.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $994.39 / $2,150.35 / $8,916.66	Professional		$994.39	$2,150.35	$8,916.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.78 / $619.61 / $2,056.43	Professional		$81.78	$619.61	$2,056.43
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,426.85 / $1,973.15 / $2,099.78	Facility		$1,426.85	$1,973.15	$2,099.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,392.98 / $1,432.24 / $6,526.97	Facility		$1,392.98	$1,432.24	$6,526.97
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,597.92 / $2,278.42 / $2,842.85	Professional		$1,597.92	$2,278.42	$2,842.85
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 $1,420.65 / $2,039.21 / $2,736.80	Professional		$1,420.65	$2,039.21	$2,736.80
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $6,096.98 / $11,941.00	Facility		$2,155.00	$6,096.98	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,255.38 / $1,703.73 / $3,002.70	Professional		$1,255.38	$1,703.73	$3,002.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $872.10 / $872.10 / $1,126.74	Professional		$872.10	$872.10	$1,126.74