Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,092.93 / $5,116.62 / $26,915.20	Facility		$1,092.93	$5,116.62	$26,915.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $627.79 / $958.44 / $2,723.09	Professional		$627.79	$958.44	$2,723.09
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,818.80 / $20,273.81 / $27,396.88	Facility		$2,818.80	$20,273.81	$27,396.88
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $156.26 / $275.06 / $275.06	Facility	AS	$156.26	$275.06	$275.06
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,013.30 / $1,931.52 / $7,524.00	Professional		$1,013.30	$1,931.52	$7,524.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,005.16 / $1,223.70 / $10,603.90	Facility		$1,005.16	$1,223.70	$10,603.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $766.47 / $1,448.87 / $2,852.71	Professional		$766.47	$1,448.87	$2,852.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $815.08 / $1,471.31 / $7,144.42	Facility		$815.08	$1,471.31	$7,144.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $805.14 / $1,452.77 / $4,600.50	Professional		$805.14	$1,452.77	$4,600.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.54 / $599.12 / $1,980.84	Professional		$116.54	$599.12	$1,980.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,135.71 / $1,778.88 / $2,034.79	Facility		$1,135.71	$1,778.88	$2,034.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,353.56 / $1,387.91 / $8,524.54	Facility		$1,353.56	$1,387.91	$8,524.54
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $981.95 / $1,514.38 / $2,504.67	Professional		$981.95	$1,514.38	$2,504.67
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,546.63 / $20,262.22 / $38,781.51	Facility		$12,546.63	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $944.09 / $1,463.29 / $2,491.86	Professional		$944.09	$1,463.29	$2,491.86
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,568.00 / $12,835.00	Facility		$2,155.00	$3,568.00	$12,835.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,139.00 / $1,573.73 / $2,901.33	Professional		$1,139.00	$1,573.73	$2,901.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $651.38 / $831.52 / $1,122.96	Professional		$651.38	$831.52	$1,122.96