Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,491.18 / $5,128.00 / $18,800.00	Facility		$1,491.18	$5,128.00	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $977.81 / $1,491.18 / $2,724.83	Professional		$977.81	$1,491.18	$2,724.83
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 $1,494.47 / $2,558.39 / $9,367.79	Professional		$1,494.47	$2,558.39	$9,367.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $644.92 / $1,110.00 / $6,910.09	Facility		$644.92	$1,110.00	$6,910.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,237.64 / $1,873.36 / $3,261.44	Professional		$1,237.64	$1,873.36	$3,261.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,404.48 / $2,341.17 / $6,320.69	Facility		$1,404.48	$2,341.17	$6,320.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,404.48 / $2,345.85 / $6,059.92	Professional		$1,404.48	$2,345.85	$6,059.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $405.97 / $2,338.57	Professional		$71.55	$405.97	$2,338.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,532.23 / $1,997.69 / $2,166.11	Facility		$1,532.23	$1,997.69	$2,166.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,444.62 / $1,477.48 / $2,952.04	Facility		$1,444.62	$1,477.48	$2,952.04
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,494.47 / $2,453.90 / $2,932.65	Professional		$1,494.47	$2,453.90	$2,932.65
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 $1,456.10 / $2,087.86 / $2,793.33	Professional		$1,456.10	$2,087.86	$2,793.33
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 $1,321.32 / $1,683.43 / $3,114.54	Professional		$1,321.32	$1,683.43	$3,114.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,163.74 / $1,163.74 / $1,163.74	Professional		$1,163.74	$1,163.74	$1,163.74