Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $7,863.94 / $22,024.00	Facility		$1,733.00	$7,863.94	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,247.06 / $1,760.75 / $3,524.21	Professional		$1,247.06	$1,760.75	$3,524.21
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $11,500.00 / $36,469.56 / $71,345.31	Facility		$11,500.00	$36,469.56	$71,345.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,797.37 / $2,929.18 / $11,103.08	Professional		$1,797.37	$2,929.18	$11,103.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.20 / $1,075.31 / $22,293.06	Facility		$883.20	$1,075.31	$22,293.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,306.14 / $2,267.00 / $3,846.90	Professional		$1,306.14	$2,267.00	$3,846.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,323.38 / $2,688.43 / $19,550.28	Facility		$1,323.38	$2,688.43	$19,550.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,199.80 / $2,583.17 / $16,834.57	Professional		$1,199.80	$2,583.17	$16,834.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $780.59 / $2,502.58	Professional		$157.37	$780.59	$2,502.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,743.64 / $2,393.23 / $2,555.38	Facility		$1,743.64	$2,393.23	$2,555.38
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,691.05 / $1,743.00 / $23,065.03	Facility		$1,691.05	$1,743.00	$23,065.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,941.65 / $2,772.78 / $3,459.68	Professional		$1,941.65	$2,772.78	$3,459.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $24,749.60 / $37,275.87 / $71,345.31	Facility		$24,749.60	$37,275.87	$71,345.31
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,724.65 / $2,480.92 / $3,325.52	Professional		$1,724.65	$2,480.92	$3,325.52
United Facility/Professional Facility Modifier Low / Median / High Price $2,853.00 / $5,851.00 / $20,708.00	Facility		$2,853.00	$5,851.00	$20,708.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,523.51 / $1,958.78 / $3,648.63	Professional		$1,523.51	$1,958.78	$3,648.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,062.58 / $1,062.58 / $1,375.88	Professional		$1,062.58	$1,062.58	$1,375.88