Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,128.00 / $21,917.86	Facility		$1,733.00	$5,128.00	$21,917.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,042.75 / $1,558.91 / $3,417.75	Professional		$1,042.75	$1,558.91	$3,417.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,689.99 / $20,262.22 / $38,781.51	Facility		$1,689.99	$20,262.22	$38,781.51
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,753.52 / $2,741.49 / $10,766.03	Professional		$1,753.52	$2,741.49	$10,766.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $2,285.42 / $10,540.05	Facility		$714.97	$2,285.42	$10,540.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,227.36 / $2,198.44 / $3,723.98	Professional		$1,227.36	$2,198.44	$3,723.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,286.29 / $2,601.84 / $9,243.26	Facility		$1,286.29	$2,601.84	$9,243.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,177.75 / $2,549.10 / $7,959.30	Professional		$1,177.75	$2,549.10	$7,959.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $156.04 / $711.25 / $2,423.25	Professional		$156.04	$711.25	$2,423.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,738.03 / $2,343.66 / $2,477.66	Facility		$1,738.03	$2,343.66	$2,477.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,645.30 / $1,689.99 / $8,497.21	Facility		$1,645.30	$1,689.99	$8,497.21
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,885.65 / $2,688.45 / $3,354.46	Professional		$1,885.65	$2,688.45	$3,354.46
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 $1,677.98 / $2,411.01 / $3,202.47	Professional		$1,677.98	$2,411.01	$3,202.47
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 $1,477.16 / $2,018.50 / $3,498.67	Professional		$1,477.16	$2,018.50	$3,498.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,029.18 / $1,029.18 / $1,326.80	Professional		$1,029.18	$1,029.18	$1,326.80