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 $3,298.40 / $15,988.64 / $21,602.23	Facility		$3,298.40	$15,988.64	$21,602.23
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,851.50 / $3,027.87 / $11,314.28	Professional		$1,851.50	$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 $1,276.78 / $2,264.89 / $3,824.15	Professional		$1,276.78	$2,264.89	$3,824.15
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,404.75 / $2,696.78 / $5,167.68	Facility		$1,404.75	$2,696.78	$5,167.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,216.85 / $2,557.03 / $3,829.02	Professional		$1,216.85	$2,557.03	$3,829.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.09 / $461.23 / $2,852.94	Professional		$109.09	$461.23	$2,852.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,803.69 / $2,449.67 / $2,574.14	Facility		$1,803.69	$2,449.67	$2,574.14
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,732.73 / $2,429.53 / $3,875.03	Facility		$1,732.73	$2,429.53	$3,875.03
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 $12,479.97 / $16,351.48 / $31,278.54	Facility		$12,479.97	$16,351.48	$31,278.54
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,046.38 / $2,525.73 / $3,339.49	Professional		$2,046.38	$2,525.73	$3,339.49
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 $1,416.63 / $2,352.62 / $3,693.05	Professional		$1,416.63	$2,352.62	$3,693.05
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