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 $1,125.27 / $1,547.61 / $3,375.52	Professional		$1,125.27	$1,547.61	$3,375.52
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,679.48 / $18,220.34 / $35,644.43	Facility		$1,679.48	$18,220.34	$35,644.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,728.72 / $2,648.37 / $10,751.99	Professional		$1,728.72	$2,648.37	$10,751.99
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 $1,276.45 / $2,182.73 / $3,702.34	Professional		$1,276.45	$2,182.73	$3,702.34
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,163.74 / $2,397.69 / $3,366.21	Facility		$1,163.74	$2,397.69	$3,366.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,163.74 / $2,356.44 / $3,085.27	Professional		$1,163.74	$2,356.44	$3,085.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $156.04 / $713.26 / $2,400.51	Professional		$156.04	$713.26	$2,400.51
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,703.24 / $2,310.19 / $2,462.25	Facility		$1,703.24	$2,310.19	$2,462.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,631.71 / $1,631.71 / $1,679.48	Facility		$1,631.71	$1,631.71	$1,679.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,871.26 / $2,671.73 / $3,333.59	Professional		$1,871.26	$2,671.73	$3,333.59
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 $1,664.12 / $2,390.51 / $3,182.55	Professional		$1,664.12	$2,390.51	$3,182.55
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 $1,475.04 / $2,001.84 / $3,516.35	Professional		$1,475.04	$2,001.84	$3,516.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,022.83 / $1,022.83 / $1,320.39	Professional		$1,022.83	$1,022.83	$1,320.39