Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,394.35 / $5,128.00 / $22,024.00	Facility		$1,394.35	$5,128.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $678.17 / $895.19 / $2,012.10	Professional		$678.17	$895.19	$2,012.10
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,722.80 / $16,547.20 / $26,542.00	Facility		$3,722.80	$16,547.20	$26,542.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,090.43 / $1,710.73 / $6,710.08	Professional		$1,090.43	$1,710.73	$6,710.08
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 $720.58 / $1,352.83 / $2,286.35	Professional		$720.58	$1,352.83	$2,286.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $843.00 / $1,617.40 / $6,059.92	Facility		$843.00	$1,617.40	$6,059.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $709.03 / $1,509.56 / $4,655.70	Professional		$709.03	$1,509.56	$4,655.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.76 / $861.95 / $1,742.78	Professional		$98.76	$861.95	$1,742.78
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,049.08 / $1,412.36 / $1,498.79	Facility		$1,049.08	$1,412.36	$1,498.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,003.40 / $1,994.21 / $3,953.90	Facility		$1,003.40	$1,994.21	$3,953.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,059.38 / $1,701.37 / $2,038.61	Professional		$1,059.38	$1,701.37	$2,038.61
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 $1,185.02 / $1,470.60 / $1,921.58	Professional		$1,185.02	$1,470.60	$1,921.58
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 $762.15 / $1,229.80 / $2,158.87	Professional		$762.15	$1,229.80	$2,158.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $619.50 / $825.91 / $825.91	Professional		$619.50	$825.91	$825.91