Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,738.39 / $4,500.00 / $20,680.40	Facility		$1,738.39	$4,500.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,137.64 / $1,654.53 / $3,302.94	Professional		$1,137.64	$1,654.53	$3,302.94
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,755.79 / $14,630.00 / $17,713.68	Facility		$1,755.79	$14,630.00	$17,713.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,847.09 / $3,027.87 / $11,314.28	Professional		$1,847.09	$3,027.87	$11,314.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $714.97 / $947.00	Facility		$500.00	$714.97	$947.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,273.60 / $2,264.89 / $3,824.15	Professional		$1,273.60	$2,264.89	$3,824.15
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,202.18 / $2,452.06 / $3,212.19	Facility		$1,202.18	$2,452.06	$3,212.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,202.18 / $2,452.06 / $3,219.98	Professional		$1,202.18	$2,452.06	$3,219.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $80.44 / $450.85 / $2,900.23	Professional		$80.44	$450.85	$2,900.23
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,900.20 / $2,449.67 / $2,574.14	Facility		$1,900.20	$2,449.67	$2,574.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,732.73 / $3,277.62 / $6,637.66	Facility		$1,732.73	$3,277.62	$6,637.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,836.00 / $2,910.44 / $3,512.88	Professional		$1,836.00	$2,910.44	$3,512.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,003.37 / $5,003.37 / $9,245.94	Facility		$5,003.37	$5,003.37	$9,245.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,046.38 / $2,525.73 / $3,327.17	Professional		$2,046.38	$2,525.73	$3,327.17
United Facility/Professional Facility Modifier Low / Median / High Price $1,300.00 / $2,759.00 / $11,941.00	Facility		$1,300.00	$2,759.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,416.63 / $2,236.80 / $3,847.96	Professional		$1,416.63	$2,236.80	$3,847.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,066.45 / $1,342.50 / $1,342.50	Professional		$1,066.45	$1,342.50	$1,342.50