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 $1,194.30 / $1,614.64 / $3,457.87	Professional		$1,194.30	$1,614.64	$3,457.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,750.77 / $8,418.45 / $16,103.56	Facility		$1,750.77	$8,418.45	$16,103.56
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,816.80 / $2,947.83 / $11,152.73	Professional		$1,816.80	$2,947.83	$11,152.73
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 $1,325.78 / $2,277.12 / $3,854.59	Professional		$1,325.78	$2,277.12	$3,854.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,216.95 / $2,485.52 / $3,489.05	Facility		$1,216.95	$2,485.52	$3,489.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,206.21 / $2,434.80 / $3,205.90	Professional		$1,206.21	$2,434.80	$3,205.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $156.75 / $722.78 / $2,475.00	Professional		$156.75	$722.78	$2,475.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,789.97 / $2,447.51 / $2,566.77	Facility		$1,789.97	$2,447.51	$2,566.77
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,708.26 / $1,708.26 / $1,750.77	Facility		$1,708.26	$1,708.26	$1,750.77
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,955.01 / $2,790.54 / $3,475.10	Professional		$1,955.01	$2,790.54	$3,475.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,430.39 / $8,418.45 / $16,103.56	Facility		$6,430.39	$8,418.45	$16,103.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,742.20 / $2,491.98 / $3,317.65	Professional		$1,742.20	$2,491.98	$3,317.65
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,129.00 / $11,941.00	Facility		$2,155.00	$3,129.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,551.00 / $2,092.75 / $3,644.19	Professional		$1,551.00	$2,092.75	$3,644.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,065.33 / $1,065.33 / $1,368.61	Professional		$1,065.33	$1,065.33	$1,368.61