Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,941.78 / $5,132.00 / $22,024.00	Facility		$1,941.78	$5,132.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,310.73 / $1,941.78 / $4,209.60	Professional		$1,310.73	$1,941.78	$4,209.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,107.67 / $18,220.34 / $35,644.43	Facility		$2,107.67	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,135.67 / $3,551.06 / $13,425.00	Professional		$2,135.67	$3,551.06	$13,425.00
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 $1,546.11 / $2,730.28 / $4,635.54	Professional		$1,546.11	$2,730.28	$4,635.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,376.09 / $2,552.42 / $4,252.14	Facility		$1,376.09	$2,552.42	$4,252.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,376.09 / $2,482.71 / $3,886.19	Professional		$1,376.09	$2,482.71	$3,886.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $896.62 / $3,003.78	Professional		$157.37	$896.62	$3,003.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,789.30 / $2,907.60 / $3,090.04	Facility		$1,789.30	$2,907.60	$3,090.04
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,057.07 / $2,057.07 / $2,107.67	Facility		$2,057.07	$2,057.07	$2,107.67
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,354.75 / $3,360.34 / $4,183.55	Professional		$2,354.75	$3,360.34	$4,183.55
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 $2,097.94 / $3,000.01 / $3,993.99	Professional		$2,097.94	$3,000.01	$3,993.99
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 $1,467.03 / $2,537.07 / $4,424.89	Professional		$1,467.03	$2,537.07	$4,424.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,283.99 / $1,283.99 / $1,646.14	Professional		$1,283.99	$1,283.99	$1,646.14