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 $1,128.64 / $1,547.09 / $3,442.07	Professional		$1,128.64	$1,547.09	$3,442.07
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,681.76 / $18,220.34 / $35,644.43	Facility		$1,681.76	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,744.05 / $2,833.18 / $10,713.98	Professional		$1,744.05	$2,833.18	$10,713.98
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 $1,273.76 / $2,187.32 / $3,705.13	Professional		$1,273.76	$2,187.32	$3,705.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,167.25 / $2,396.21 / $3,339.31	Facility		$1,167.25	$2,396.21	$3,339.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,154.44 / $2,340.96 / $3,065.02	Professional		$1,154.44	$2,340.96	$3,065.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $156.75 / $716.34 / $2,401.18	Professional		$156.75	$716.34	$2,401.18
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,694.30 / $2,342.98 / $2,465.60	Facility		$1,694.30	$2,342.98	$2,465.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,639.86 / $1,639.86 / $1,681.76	Facility		$1,639.86	$1,639.86	$1,681.76
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,876.91 / $2,678.80 / $3,338.13	Professional		$1,876.91	$2,678.80	$3,338.13
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 $1,672.44 / $2,393.77 / $3,186.88	Professional		$1,672.44	$2,393.77	$3,186.88
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 $1,512.00 / $2,045.08 / $3,526.98	Professional		$1,512.00	$2,045.08	$3,526.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,023.93 / $1,023.93 / $1,317.92	Professional		$1,023.93	$1,023.93	$1,317.92