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 $1,023.76 / $1,324.75 / $2,895.11	Professional		$1,023.76	$1,324.75	$2,895.11
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,436.35 / $18,220.34 / $35,644.43	Facility		$1,436.35	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,499.38 / $2,423.92 / $9,150.83	Professional		$1,499.38	$2,423.92	$9,150.83
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 $1,094.89 / $1,868.48 / $3,157.99	Professional		$1,094.89	$1,868.48	$3,157.99
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,032.17 / $2,059.17 / $2,879.30	Facility		$1,032.17	$2,059.17	$2,879.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,003.45 / $2,017.16 / $2,649.42	Professional		$1,003.45	$2,017.16	$2,649.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.28 / $626.35 / $2,080.12	Professional		$116.28	$626.35	$2,080.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,481.76 / $1,984.65 / $2,105.81	Facility		$1,481.76	$1,984.65	$2,105.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,405.66 / $1,405.66 / $1,436.35	Facility		$1,405.66	$1,405.66	$1,436.35
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,605.63 / $2,296.21 / $2,851.02	Professional		$1,605.63	$2,296.21	$2,851.02
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 $1,433.59 / $2,044.46 / $2,721.84	Professional		$1,433.59	$2,044.46	$2,721.84
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 $1,255.48 / $1,718.76 / $3,017.20	Professional		$1,255.48	$1,718.76	$3,017.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $873.48 / $873.48 / $1,119.10	Professional		$873.48	$873.48	$1,119.10