Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,227.54 / $5,128.00 / $20,680.40	Facility		$1,227.54	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $953.96 / $1,227.54 / $2,602.90	Professional		$953.96	$1,227.54	$2,602.90
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,328.96 / $18,220.34 / $35,644.43	Facility		$1,328.96	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,367.92 / $2,228.00 / $8,464.73	Professional		$1,367.92	$2,228.00	$8,464.73
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 $984.62 / $1,733.92 / $2,933.37	Professional		$984.62	$1,733.92	$2,933.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $904.40 / $1,859.10 / $2,595.94	Facility		$904.40	$1,859.10	$2,595.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $897.45 / $1,817.09 / $2,393.76	Professional		$897.45	$1,817.09	$2,393.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.54 / $602.29 / $1,875.04	Professional		$81.54	$602.29	$1,875.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,327.41 / $1,813.69 / $1,948.36	Facility		$1,327.41	$1,813.69	$1,948.36
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,296.94 / $1,296.94 / $1,328.96	Facility		$1,296.94	$1,296.94	$1,328.96
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,484.88 / $2,118.62 / $2,637.85	Professional		$1,484.88	$2,118.62	$2,637.85
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $14,233.34 / $18,989.06 / $35,644.43	Facility		$14,233.34	$18,989.06	$35,644.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,322.71 / $1,891.60 / $2,543.19	Professional		$1,322.71	$1,891.60	$2,543.19
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 $1,127.49 / $1,539.99 / $2,790.30	Professional		$1,127.49	$1,539.99	$2,790.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $808.33 / $808.33 / $1,046.45	Professional		$808.33	$808.33	$1,046.45