Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,851.75 / $5,132.00 / $22,024.00	Facility		$1,851.75	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,342.89 / $1,851.75 / $3,982.99	Professional		$1,342.89	$1,851.75	$3,982.99
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,010.80 / $18,220.34 / $35,644.43	Facility		$2,010.80	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,091.86 / $3,359.81 / $13,557.05	Professional		$2,091.86	$3,359.81	$13,557.05
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 $1,537.03 / $2,612.98 / $4,422.70	Professional		$1,537.03	$2,612.98	$4,422.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,410.85 / $2,893.06 / $4,045.91	Facility		$1,410.85	$2,893.06	$4,045.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,398.72 / $2,834.02 / $3,705.25	Professional		$1,398.72	$2,834.02	$3,705.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $873.18 / $2,847.41	Professional		$157.37	$873.18	$2,847.41
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,080.54 / $2,821.37 / $2,948.00	Facility		$2,080.54	$2,821.37	$2,948.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,961.94 / $1,961.94 / $2,010.80	Facility		$1,961.94	$1,961.94	$2,010.80
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,244.79 / $3,204.94 / $3,991.24	Professional		$2,244.79	$3,204.94	$3,991.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,233.34 / $18,633.84 / $35,644.43	Facility		$14,233.34	$18,633.84	$35,644.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,000.92 / $2,862.11 / $3,810.40	Professional		$2,000.92	$2,862.11	$3,810.40
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 $1,780.80 / $2,377.76 / $4,197.60	Professional		$1,780.80	$2,377.76	$4,197.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,224.08 / $1,224.08 / $1,569.88	Professional		$1,224.08	$1,224.08	$1,569.88