Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,579.99 / $4,500.00 / $20,680.40	Facility		$1,579.99	$4,500.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $856.46 / $1,179.28 / $2,495.94	Professional		$856.46	$1,179.28	$2,495.94
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,276.85 / $18,220.34 / $35,644.43	Facility		$1,276.85	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,314.30 / $2,138.81 / $14,015.54	Professional		$1,314.30	$2,138.81	$14,015.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $765.00 / $870.49	Facility		$714.97	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $959.83 / $1,663.13 / $2,817.43	Professional		$959.83	$1,663.13	$2,817.43
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $877.11 / $1,798.07 / $2,531.38	Facility		$877.11	$1,798.07	$2,531.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $875.13 / $1,770.69 / $2,318.35	Professional		$875.13	$1,770.69	$2,318.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.46 / $586.21 / $1,837.79	Professional		$81.46	$586.21	$1,837.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,295.07 / $1,735.09 / $1,871.98	Facility		$1,295.07	$1,735.09	$1,871.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,242.13 / $1,242.13 / $1,276.85	Facility		$1,242.13	$1,242.13	$1,276.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,424.49 / $2,031.24 / $2,534.44	Professional		$1,424.49	$2,031.24	$2,534.44
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 $1,266.80 / $1,817.44 / $2,419.60	Professional		$1,266.80	$1,817.44	$2,419.60
United Facility/Professional Facility Modifier Low / Median / High Price $4,241.00 / $5,478.00 / $11,540.00	Facility		$4,241.00	$5,478.00	$11,540.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,120.07 / $1,509.87 / $2,634.35	Professional		$1,120.07	$1,509.87	$2,634.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $777.95 / $777.95 / $1,006.63	Professional		$777.95	$777.95	$1,006.63