Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,407.45 / $2,628.03 / $22,024.00	Facility		$1,407.45	$2,628.03	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,010.37 / $1,407.45 / $2,961.88	Professional		$1,010.37	$1,407.45	$2,961.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,520.44 / $19,056.41 / $38,781.51	Facility		$1,520.44	$19,056.41	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,565.02 / $2,542.98 / $9,684.23	Professional		$1,565.02	$2,542.98	$9,684.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $765.00 / $870.49	Facility		$714.97	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,085.06 / $1,983.20 / $3,359.05	Professional		$1,085.06	$1,983.20	$3,359.05
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,070.09 / $2,258.37 / $6,397.05	Facility		$1,070.09	$2,258.37	$6,397.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,036.64 / $2,176.16 / $5,065.67	Professional		$1,036.64	$2,176.16	$5,065.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.13 / $629.87 / $2,162.22	Professional		$116.13	$629.87	$2,162.22
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,332.63 / $1,869.66 / $2,229.09	Facility		$1,332.63	$1,869.66	$2,229.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,478.59 / $1,478.59 / $1,520.44	Facility		$1,478.59	$1,478.59	$1,520.44
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,696.75 / $2,418.73 / $3,017.92	Professional		$1,696.75	$2,418.73	$3,017.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $13,146.66 / $20,262.22 / $38,781.51	Facility		$13,146.66	$20,262.22	$38,781.51
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,507.97 / $2,164.14 / $2,906.64	Professional		$1,507.97	$2,164.14	$2,906.64
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 $1,229.67 / $1,816.64 / $3,137.84	Professional		$1,229.67	$1,816.64	$3,137.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $925.93 / $925.93 / $1,202.07	Professional		$925.93	$925.93	$1,202.07