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 $1,099.49 / $1,426.08 / $3,530.29	Professional		$1,099.49	$1,426.08	$3,530.29
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,546.95 / $18,220.34 / $35,644.43	Facility		$1,546.95	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,592.30 / $2,554.34 / $9,855.53	Professional		$1,592.30	$2,554.34	$9,855.53
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 $1,125.46 / $2,011.22 / $3,408.89	Professional		$1,125.46	$2,011.22	$3,408.89
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,070.74 / $2,171.71 / $3,097.20	Facility		$1,070.74	$2,171.71	$3,097.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,070.74 / $2,154.65 / $2,840.49	Professional		$1,070.74	$2,154.65	$2,840.49
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 $1,652.06 / $2,168.79 / $2,267.94	Facility		$1,652.06	$2,168.79	$2,267.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,504.41 / $1,504.41 / $1,546.95	Facility		$1,504.41	$1,504.41	$1,546.95
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,724.83 / $2,460.90 / $3,070.53	Professional		$1,724.83	$2,460.90	$3,070.53
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 $1,534.30 / $2,201.87 / $2,931.41	Professional		$1,534.30	$2,201.87	$2,931.41
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 $1,318.33 / $1,845.09 / $3,204.63	Professional		$1,318.33	$1,845.09	$3,204.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $941.94 / $941.94 / $1,214.66	Professional		$941.94	$941.94	$1,214.66