Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $6,470.00 / $25,612.66	Facility		$1,733.00	$6,470.00	$25,612.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $992.36 / $1,272.78 / $2,742.43	Professional		$992.36	$1,272.78	$2,742.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,004.24 / $16,547.20 / $26,542.00	Facility		$4,004.24	$16,547.20	$26,542.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,557.35 / $2,500.79 / $11,430.60	Professional		$1,557.35	$2,500.79	$11,430.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,005.16 / $1,223.70 / $6,910.09	Facility		$1,005.16	$1,223.70	$6,910.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,061.34 / $1,941.24 / $3,265.37	Professional		$1,061.34	$1,941.24	$3,265.37
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,202.61 / $2,352.37 / $6,320.69	Facility		$1,202.61	$2,352.37	$6,320.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,064.23 / $2,225.02 / $4,655.70	Professional		$1,064.23	$2,225.02	$4,655.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.44 / $388.92 / $2,423.66	Professional		$80.44	$388.92	$2,423.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,532.72 / $2,014.69 / $2,173.28	Facility		$1,532.72	$2,014.69	$2,173.28
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,447.79 / $1,994.21 / $5,930.48	Facility		$1,447.79	$1,994.21	$5,930.48
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,534.08 / $2,453.90 / $2,961.84	Professional		$1,534.08	$2,453.90	$2,961.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,761.59 / $16,595.73 / $31,745.76	Facility		$10,761.59	$16,595.73	$31,745.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,709.86 / $2,124.06 / $2,798.05	Professional		$1,709.86	$2,124.06	$2,798.05
United Facility/Professional Facility Modifier Low / Median / High Price $1,400.00 / $3,509.00 / $16,315.00	Facility		$1,400.00	$3,509.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,204.58 / $1,870.30 / $3,138.30	Professional		$1,204.58	$1,870.30	$3,138.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $898.60 / $1,165.70 / $1,165.70	Professional		$898.60	$1,165.70	$1,165.70