Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,499.90 / $5,132.00 / $22,024.00	Facility		$1,499.90	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $769.72 / $1,132.16 / $2,228.21	Professional		$769.72	$1,132.16	$2,228.21
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,147.98 / $18,220.34 / $35,644.43	Facility		$1,147.98	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,181.64 / $1,896.16 / $7,312.28	Professional		$1,181.64	$1,896.16	$7,312.28
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 $844.53 / $1,494.70 / $2,533.37	Professional		$844.53	$1,494.70	$2,533.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $765.78 / $1,565.58 / $2,136.83	Facility		$765.78	$1,565.58	$2,136.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $751.13 / $1,497.65 / $2,062.51	Professional		$751.13	$1,497.65	$2,062.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.54 / $438.42 / $1,642.99	Professional		$78.54	$438.42	$1,642.99
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,158.44 / $1,542.11 / $1,683.04	Facility		$1,158.44	$1,542.11	$1,683.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,090.82 / $1,090.82 / $1,147.98	Facility		$1,090.82	$1,090.82	$1,147.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,280.14 / $1,826.22 / $2,278.64	Professional		$1,280.14	$1,826.22	$2,278.64
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 $1,112.50 / $1,634.00 / $2,175.39	Professional		$1,112.50	$1,634.00	$2,175.39
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 $1,001.00 / $1,357.48 / $2,406.03	Professional		$1,001.00	$1,357.48	$2,406.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $699.56 / $699.56 / $905.44	Professional		$699.56	$699.56	$905.44