Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,104.83 / $3,810.00 / $18,711.00	Facility		$1,104.83	$3,810.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $697.84 / $996.36 / $2,055.21	Professional		$697.84	$996.36	$2,055.21
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,028.31 / $5,201.18 / $16,394.00	Facility		$1,028.31	$5,201.18	$16,394.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,089.59 / $1,814.28 / $6,585.23	Professional		$1,089.59	$1,814.28	$6,585.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $1,557.08	Facility		$625.25	$761.81	$1,557.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $702.66 / $1,391.19 / $2,333.44	Professional		$702.66	$1,391.19	$2,333.44
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $776.65 / $1,459.65 / $2,420.62	Facility		$776.65	$1,459.65	$2,420.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $750.20 / $1,428.60 / $1,973.10	Professional		$750.20	$1,428.60	$1,973.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.76 / $866.96 / $1,780.95	Professional		$98.76	$866.96	$1,780.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,094.17 / $1,455.91 / $1,540.88	Facility		$1,094.17	$1,455.91	$1,540.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $541.04 / $1,028.31 / $1,042.86	Facility		$541.04	$1,028.31	$1,042.86
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,087.10 / $1,740.18 / $2,100.38	Professional		$1,087.10	$1,740.18	$2,100.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,301.18 / $4,321.81 / $8,267.12	Facility		$3,301.18	$4,321.81	$8,267.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,214.45 / $1,500.18 / $1,960.24	Professional		$1,214.45	$1,500.18	$1,960.24
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $1,120.00 / $6,857.00	Facility		$650.00	$1,120.00	$6,857.00
United Facility/Professional Professional Modifier Low / Median / High Price $812.79 / $1,272.14 / $2,208.10	Professional		$812.79	$1,272.14	$2,208.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $628.04 / $838.15 / $838.15	Professional		$628.04	$838.15	$838.15