Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,612.58 / $5,128.00 / $21,917.86	Facility		$1,612.58	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $809.38 / $1,115.22 / $2,454.98	Professional		$809.38	$1,115.22	$2,454.98
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,492.08 / $9,172.83 / $20,286.13	Facility		$4,492.08	$9,172.83	$20,286.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,242.80 / $1,993.56 / $7,690.65	Professional		$1,242.80	$1,993.56	$7,690.65
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 $904.92 / $1,572.32 / $2,665.81	Professional		$904.92	$1,572.32	$2,665.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $916.73 / $1,839.64 / $3,280.24	Facility		$916.73	$1,839.64	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $834.50 / $1,765.83 / $2,880.24	Professional		$834.50	$1,765.83	$2,880.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.45 / $569.66 / $1,731.94	Professional		$81.45	$569.66	$1,731.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,221.57 / $1,670.31 / $1,770.14	Facility		$1,221.57	$1,670.31	$1,770.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $986.25 / $1,173.72 / $2,961.46	Facility		$986.25	$1,173.72	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,346.16 / $1,920.73 / $2,396.56	Professional		$1,346.16	$1,920.73	$2,396.56
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,006.61 / $9,172.83 / $17,546.59	Facility		$7,006.61	$9,172.83	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,197.04 / $1,718.56 / $2,287.96	Professional		$1,197.04	$1,718.56	$2,287.96
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $4,016.00 / $16,315.00	Facility		$2,912.00	$4,016.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,055.34 / $1,427.74 / $2,529.60	Professional		$1,055.34	$1,427.74	$2,529.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $735.17 / $735.17 / $952.99	Professional		$735.17	$735.17	$952.99