Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $6,470.00 / $21,917.86	Facility		$1,733.00	$6,470.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,095.75 / $1,415.06 / $3,140.86	Professional		$1,095.75	$1,415.06	$3,140.86
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,534.15 / $8,418.45 / $16,103.56	Facility		$1,534.15	$8,418.45	$16,103.56
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,595.06 / $2,535.32 / $9,774.00	Professional		$1,595.06	$2,535.32	$9,774.00
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 $1,160.33 / $1,995.69 / $3,379.59	Professional		$1,160.33	$1,995.69	$3,379.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,065.40 / $2,184.73 / $3,057.74	Facility		$1,065.40	$2,184.73	$3,057.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,057.09 / $2,140.15 / $2,806.15	Professional		$1,057.09	$2,140.15	$2,806.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.51 / $631.56 / $2,165.29	Professional		$116.51	$631.56	$2,165.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,555.73 / $2,141.32 / $2,249.19	Facility		$1,555.73	$2,141.32	$2,249.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,494.90 / $1,494.90 / $1,534.15	Facility		$1,494.90	$1,494.90	$1,534.15
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,711.98 / $2,442.00 / $3,045.13	Professional		$1,711.98	$2,442.00	$3,045.13
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 $1,524.60 / $2,183.66 / $2,907.16	Professional		$1,524.60	$2,183.66	$2,907.16
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 $1,348.20 / $1,838.03 / $3,217.04	Professional		$1,348.20	$1,838.03	$3,217.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $933.66 / $933.66 / $1,202.82	Professional		$933.66	$933.66	$1,202.82