Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,380.81 / $3,810.00 / $18,711.00	Facility		$1,380.81	$3,810.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $943.45 / $1,324.21 / $2,638.72	Professional		$943.45	$1,324.21	$2,638.72
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $8,353.03 / $12,053.91	Facility		$55.00	$8,353.03	$12,053.91
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,465.40 / $2,420.36 / $8,788.79	Professional		$1,465.40	$2,420.36	$8,788.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $870.49 / $947.00	Facility		$500.00	$870.49	$947.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,003.71 / $1,833.38 / $3,077.26	Professional		$1,003.71	$1,833.38	$3,077.26
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,126.27 / $2,026.04 / $3,100.31	Facility		$1,126.27	$2,026.04	$3,100.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $959.66 / $1,938.14 / $2,586.90	Professional		$959.66	$1,938.14	$2,586.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $148.17 / $1,191.59 / $2,383.21	Professional		$148.17	$1,191.59	$2,383.21
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,446.97 / $1,968.46 / $2,051.54	Facility		$1,446.97	$1,968.46	$2,051.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,362.17 / $1,362.17 / $1,399.33	Facility		$1,362.17	$1,362.17	$1,399.33
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,454.71 / $2,321.51 / $2,778.55	Professional		$1,454.71	$2,321.51	$2,778.55
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,916.52 / $9,118.81 / $17,453.22	Facility		$5,916.52	$9,118.81	$17,453.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,608.75 / $2,012.96 / $2,630.26	Professional		$1,608.75	$2,012.96	$2,630.26
United Facility/Professional Facility Modifier Low / Median / High Price $2,038.00 / $11,242.66 / $16,606.50	Facility		$2,038.00	$11,242.66	$16,606.50
United Facility/Professional Professional Modifier Low / Median / High Price $1,037.68 / $1,687.80 / $2,945.75	Professional		$1,037.68	$1,687.80	$2,945.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $847.80 / $1,087.09 / $1,087.09	Professional		$847.80	$1,087.09	$1,087.09