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 $1,033.60 / $1,420.75 / $3,157.30	Professional		$1,033.60	$1,420.75	$3,157.30
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,540.55 / $18,220.34 / $35,644.43	Facility		$1,540.55	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,585.72 / $2,584.94 / $9,814.58	Professional		$1,585.72	$2,584.94	$9,814.58
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 $1,164.20 / $2,004.67 / $3,395.01	Professional		$1,164.20	$2,004.67	$3,395.01
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,069.59 / $2,196.82 / $3,071.19	Facility		$1,069.59	$2,196.82	$3,071.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,061.75 / $2,151.32 / $2,816.71	Professional		$1,061.75	$2,151.32	$2,816.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.28 / $631.56 / $2,229.65	Professional		$116.28	$631.56	$2,229.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,578.50 / $2,151.37 / $2,258.57	Facility		$1,578.50	$2,151.37	$2,258.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,499.88 / $1,499.88 / $1,540.55	Facility		$1,499.88	$1,499.88	$1,540.55
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,719.17 / $2,450.71 / $3,057.83	Professional		$1,719.17	$2,450.71	$3,057.83
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 $1,529.68 / $2,192.77 / $2,919.29	Professional		$1,529.68	$2,192.77	$2,919.29
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 $1,351.97 / $1,821.68 / $3,186.80	Professional		$1,351.97	$1,821.68	$3,186.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $938.07 / $938.07 / $1,209.77	Professional		$938.07	$938.07	$1,209.77