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 $1,200.83 / $1,649.04 / $3,668.23	Professional		$1,200.83	$1,649.04	$3,668.23
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,788.24 / $35,815.01 / $70,064.83	Facility		$1,788.24	$35,815.01	$70,064.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,840.68 / $3,009.10 / $11,391.00	Professional		$1,840.68	$3,009.10	$11,391.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $765.00 / $870.49 / $870.49	Facility		$765.00	$870.49	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,353.60 / $2,326.36 / $3,939.45	Professional		$1,353.60	$2,326.36	$3,939.45
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,247.05 / $2,543.26 / $3,577.83	Facility		$1,247.05	$2,543.26	$3,577.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,236.90 / $2,491.36 / $3,286.90	Professional		$1,236.90	$2,491.36	$3,286.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $156.38 / $721.85 / $2,518.90	Professional		$156.38	$721.85	$2,518.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,806.70 / $2,498.42 / $2,621.71	Facility		$1,806.70	$2,498.42	$2,621.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,744.05 / $1,744.05 / $1,788.24	Facility		$1,744.05	$1,744.05	$1,788.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,997.14 / $2,849.00 / $3,549.48	Professional		$1,997.14	$2,849.00	$3,549.48
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $27,977.90 / $36,627.79 / $70,064.83	Facility		$27,977.90	$36,627.79	$70,064.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,778.70 / $2,545.33 / $3,388.66	Professional		$1,778.70	$2,545.33	$3,388.66
United Facility/Professional Facility Modifier Low / Median / High Price $3,028.00 / $5,547.00 / $19,271.00	Facility		$3,028.00	$5,547.00	$19,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,577.53 / $2,140.92 / $3,718.45	Professional		$1,577.53	$2,140.92	$3,718.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,088.26 / $1,088.26 / $1,398.87	Professional		$1,088.26	$1,088.26	$1,398.87