Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,612.94 / $5,132.00 / $22,024.00	Facility		$1,612.94	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $817.85 / $1,115.05 / $2,446.91	Professional		$817.85	$1,115.05	$2,446.91
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,207.84 / $18,220.34 / $35,644.43	Facility		$1,207.84	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,243.27 / $2,034.34 / $7,695.00	Professional		$1,243.27	$2,034.34	$7,695.00
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 $912.75 / $1,572.67 / $2,660.61	Professional		$912.75	$1,572.67	$2,660.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $862.20 / $1,725.49 / $2,411.21	Facility		$862.20	$1,725.49	$2,411.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $839.30 / $1,690.28 / $2,215.33	Professional		$839.30	$1,690.28	$2,215.33
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 $1,204.47 / $1,665.62 / $1,770.81	Facility		$1,204.47	$1,665.62	$1,770.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,179.60 / $1,179.60 / $1,207.84	Facility		$1,179.60	$1,179.60	$1,207.84
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,350.27 / $1,926.96 / $2,397.46	Professional		$1,350.27	$1,926.96	$2,397.46
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 $1,203.05 / $1,719.22 / $2,288.84	Professional		$1,203.05	$1,719.22	$2,288.84
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 $1,089.07 / $1,456.23 / $2,537.35	Professional		$1,089.07	$1,456.23	$2,537.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $734.34 / $734.34 / $943.82	Professional		$734.34	$734.34	$943.82