Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,633.95 / $6,470.00 / $20,680.40	Facility		$1,633.95	$6,470.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $804.03 / $1,129.57 / $2,386.96	Professional		$804.03	$1,129.57	$2,386.96
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,765.02 / $9,172.83 / $20,286.13	Facility		$3,765.02	$9,172.83	$20,286.13
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,259.73 / $2,046.12 / $7,796.48	Professional		$1,259.73	$2,046.12	$7,796.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $3,740.43	Facility		$714.97	$870.49	$3,740.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $917.52 / $1,593.15 / $2,701.63	Professional		$917.52	$1,593.15	$2,701.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $929.83 / $1,863.32 / $3,280.24	Facility		$929.83	$1,863.32	$3,280.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $850.20 / $1,794.35 / $2,880.24	Professional		$850.20	$1,794.35	$2,880.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.45 / $569.19 / $1,731.94	Professional		$81.45	$569.19	$1,731.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,238.23 / $1,693.09 / $1,794.26	Facility		$1,238.23	$1,693.09	$1,794.26
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $986.25 / $1,188.22 / $2,961.46	Facility		$986.25	$1,188.22	$2,961.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,364.14 / $1,946.91 / $2,429.21	Professional		$1,364.14	$1,946.91	$2,429.21
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,006.61 / $9,172.83 / $17,546.59	Facility		$7,006.61	$9,172.83	$17,546.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,211.83 / $1,741.99 / $2,319.15	Professional		$1,211.83	$1,741.99	$2,319.15
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $4,016.00 / $16,315.00	Facility		$2,912.00	$4,016.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,069.73 / $1,473.78 / $2,693.52	Professional		$1,069.73	$1,473.78	$2,693.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $744.83 / $744.83 / $965.07	Professional		$744.83	$744.83	$965.07