Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,646.64 / $6,470.00 / $24,827.00	Facility		$1,646.64	$6,470.00	$24,827.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,050.30 / $1,646.64 / $3,121.48	Professional		$1,050.30	$1,646.64	$3,121.48
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 $1,648.78 / $2,891.32 / $10,350.90	Professional		$1,648.78	$2,891.32	$10,350.90
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 $1,349.20 / $2,060.85 / $3,603.87	Professional		$1,349.20	$2,060.85	$3,603.87
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,461.24 / $2,514.88 / $6,320.69	Facility		$1,461.24	$2,514.88	$6,320.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,497.27 / $2,529.28 / $6,059.92	Professional		$1,497.27	$2,529.28	$6,059.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $105.08 / $460.26 / $2,599.21	Professional		$105.08	$460.26	$2,599.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,676.37 / $2,318.19 / $2,392.57	Facility		$1,676.37	$2,318.19	$2,392.57
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,593.20 / $1,631.95 / $2,952.04	Facility		$1,593.20	$1,631.95	$2,952.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,648.78 / $2,707.28 / $3,239.25	Professional		$1,648.78	$2,707.28	$3,239.25
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 $1,605.86 / $2,303.44 / $3,080.51	Professional		$1,605.86	$2,303.44	$3,080.51
United Facility/Professional Facility Modifier Low / Median / High Price $1,615.00 / $5,048.85 / $16,315.00	Facility		$1,615.00	$5,048.85	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,412.16 / $1,836.65 / $3,866.93	Professional		$1,412.16	$1,836.65	$3,866.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,285.92 / $1,285.92 / $1,285.92	Professional		$1,285.92	$1,285.92	$1,285.92