Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,729.36 / $5,128.00 / $20,680.40	Facility		$1,729.36	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $874.85 / $1,286.14 / $2,522.35	Professional		$874.85	$1,286.14	$2,522.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,994.21 / $14,442.95 / $21,924.91	Facility		$1,994.21	$14,442.95	$21,924.91
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,419.30 / $2,366.69 / $8,554.20	Professional		$1,419.30	$2,366.69	$8,554.20
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 $931.67 / $1,775.82 / $3,010.04	Professional		$931.67	$1,775.82	$3,010.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,104.54 / $2,085.82 / $6,320.69	Facility		$1,104.54	$2,085.82	$6,320.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $974.02 / $2,006.70 / $4,655.70	Professional		$974.02	$2,006.70	$4,655.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $147.70 / $1,153.92 / $2,351.48	Professional		$147.70	$1,153.92	$2,351.48
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,254.40 / $1,822.88 / $1,975.16	Facility		$1,254.40	$1,822.88	$1,975.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,331.82 / $1,994.21 / $3,953.90	Facility		$1,331.82	$1,994.21	$3,953.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,411.20 / $2,249.21 / $2,714.79	Professional		$1,411.20	$2,249.21	$2,714.79
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 $1,572.90 / $1,938.02 / $2,552.96	Professional		$1,572.90	$1,938.02	$2,552.96
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 $1,070.13 / $1,609.68 / $2,836.71	Professional		$1,070.13	$1,609.68	$2,836.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $824.34 / $1,101.05 / $1,101.05	Professional		$824.34	$1,101.05	$1,101.05