Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,132.00 / $22,024.00	Facility		$1,733.00	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,196.28 / $1,804.86 / $3,677.66	Professional		$1,196.28	$1,804.86	$3,677.66
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,781.84 / $18,220.34 / $35,644.43	Facility		$1,781.84	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,852.39 / $3,003.18 / $11,351.03	Professional		$1,852.39	$3,003.18	$11,351.03
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 $1,358.70 / $2,317.78 / $3,925.39	Professional		$1,358.70	$2,317.78	$3,925.39
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,247.40 / $2,560.04 / $3,578.72	Facility		$1,247.40	$2,560.04	$3,578.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,237.21 / $2,507.81 / $3,286.79	Professional		$1,237.21	$2,507.81	$3,286.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $156.38 / $721.85 / $2,518.90	Professional		$156.38	$721.85	$2,518.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,856.61 / $2,506.46 / $2,612.33	Facility		$1,856.61	$2,506.46	$2,612.33
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,735.90 / $1,735.90 / $1,781.84	Facility		$1,735.90	$1,735.90	$1,781.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,989.95 / $2,835.68 / $3,536.78	Professional		$1,989.95	$2,835.68	$3,536.78
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 $1,770.38 / $2,536.21 / $3,376.53	Professional		$1,770.38	$2,536.21	$3,376.53
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 $1,535.86 / $2,097.76 / $3,739.38	Professional		$1,535.86	$2,097.76	$3,739.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,084.95 / $1,084.95 / $1,394.71	Professional		$1,084.95	$1,084.95	$1,394.71