Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,638.69 / $5,132.00 / $22,024.00	Facility		$1,638.69	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $831.47 / $1,132.92 / $2,525.05	Professional		$831.47	$1,132.92	$2,525.05
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,227.05 / $18,220.34 / $35,644.43	Facility		$1,227.05	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,279.08 / $2,067.33 / $7,815.90	Professional		$1,279.08	$2,067.33	$7,815.90
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 $931.16 / $1,597.77 / $2,702.28	Professional		$931.16	$1,597.77	$2,702.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $876.84 / $1,753.02 / $2,451.57	Facility		$876.84	$1,753.02	$2,451.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $854.35 / $1,717.25 / $2,252.31	Professional		$854.35	$1,717.25	$2,252.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.72 / $527.40 / $1,733.20	Professional		$79.72	$527.40	$1,733.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,259.30 / $1,722.57 / $1,798.95	Facility		$1,259.30	$1,722.57	$1,798.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,198.64 / $1,198.64 / $1,227.05	Facility		$1,198.64	$1,198.64	$1,227.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,371.85 / $1,958.04 / $2,435.56	Professional		$1,371.85	$1,958.04	$2,435.56
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 $1,222.45 / $1,746.54 / $2,325.21	Professional		$1,222.45	$1,746.54	$2,325.21
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 $1,083.18 / $1,458.48 / $2,553.21	Professional		$1,083.18	$1,458.48	$2,553.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $747.32 / $747.32 / $959.99	Professional		$747.32	$747.32	$959.99