Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,128.00 / $21,917.86	Facility		$1,733.00	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,111.58 / $1,484.83 / $3,191.09	Professional		$1,111.58	$1,484.83	$3,191.09
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,610.01 / $18,220.34 / $35,644.43	Facility		$1,610.01	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,657.22 / $2,713.76 / $10,259.10	Professional		$1,657.22	$2,713.76	$10,259.10
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 $1,231.71 / $2,097.21 / $3,541.17	Professional		$1,231.71	$2,097.21	$3,541.17
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,128.40 / $2,320.35 / $3,230.81	Facility		$1,128.40	$2,320.35	$3,230.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,116.93 / $2,267.67 / $2,969.04	Professional		$1,116.93	$2,267.67	$2,969.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $118.54 / $699.73 / $2,282.53	Professional		$118.54	$699.73	$2,282.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,660.61 / $2,270.63 / $2,360.41	Facility		$1,660.61	$2,270.63	$2,360.41
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,565.57 / $1,565.57 / $1,610.01	Facility		$1,565.57	$1,565.57	$1,610.01
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,801.90 / $2,561.21 / $3,195.71	Professional		$1,801.90	$2,561.21	$3,195.71
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 $1,596.67 / $2,291.64 / $3,050.92	Professional		$1,596.67	$2,291.64	$3,050.92
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 $1,436.50 / $1,902.31 / $3,363.02	Professional		$1,436.50	$1,902.31	$3,363.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $981.42 / $981.42 / $1,259.33	Professional		$981.42	$981.42	$1,259.33