Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $10,122.46 / $27,982.24	Facility		$1,733.00	$10,122.46	$27,982.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $863.37 / $1,397.21 / $2,891.17	Professional		$863.37	$1,397.21	$2,891.17
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,952.04 / $16,547.20 / $31,745.76	Facility		$2,952.04	$16,547.20	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,384.25 / $2,463.85 / $9,966.91	Professional		$1,384.25	$2,463.85	$9,966.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,258.25 / $1,961.00 / $6,910.09	Facility		$1,258.25	$1,961.00	$6,910.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,149.25 / $1,741.63 / $3,060.41	Professional		$1,149.25	$1,741.63	$3,060.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,264.10 / $2,047.05 / $6,320.69	Facility		$1,264.10	$2,047.05	$6,320.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,264.10 / $2,106.85 / $6,059.92	Professional		$1,264.10	$2,106.85	$6,059.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $92.81 / $1,031.25 / $2,266.63	Professional		$92.81	$1,031.25	$2,266.63
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,396.50 / $1,930.52 / $2,029.43	Facility		$1,396.50	$1,930.52	$2,029.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,349.03 / $1,384.25 / $2,952.04	Facility		$1,349.03	$1,384.25	$2,952.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,396.69 / $2,293.35 / $2,747.61	Professional		$1,396.69	$2,293.35	$2,747.61
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,761.59 / $16,586.25 / $31,745.76	Facility		$10,761.59	$16,586.25	$31,745.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,359.75 / $1,951.26 / $2,606.58	Professional		$1,359.75	$1,951.26	$2,606.58
United Facility/Professional Facility Modifier Low / Median / High Price $1,615.00 / $3,478.00 / $16,315.00	Facility		$1,615.00	$3,478.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,180.49 / $1,516.14 / $2,936.16	Professional		$1,180.49	$1,516.14	$2,936.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,095.17 / $1,095.17 / $1,095.17	Professional		$1,095.17	$1,095.17	$1,095.17