Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,739.40 / $3,255.30 / $20,680.40	Facility		$1,739.40	$3,255.30	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,136.40 / $1,669.08 / $3,304.86	Professional		$1,136.40	$1,669.08	$3,304.86
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $5,430.85 / $17,785.43	Facility		$55.00	$5,430.85	$17,785.43
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,853.37 / $2,954.88 / $11,807.05	Professional		$1,853.37	$2,954.88	$11,807.05
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 $1,279.36 / $2,270.89 / $3,837.92	Professional		$1,279.36	$2,270.89	$3,837.92
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,206.52 / $2,444.87 / $3,220.77	Facility		$1,206.52	$2,444.87	$3,220.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,206.52 / $2,444.87 / $3,234.95	Professional		$1,206.52	$2,444.87	$3,234.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $110.83 / $459.74 / $2,818.14	Professional		$110.83	$459.74	$2,818.14
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,806.63 / $2,459.00 / $2,585.53	Facility		$1,806.63	$2,459.00	$2,585.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,739.52 / $3,277.62 / $6,637.66	Facility		$1,739.52	$3,277.62	$6,637.66
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,843.20 / $2,920.33 / $3,524.82	Professional		$1,843.20	$2,920.33	$3,524.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,054.40 / $2,536.91 / $3,314.88	Professional		$2,054.40	$2,536.91	$3,314.88
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 $1,417.99 / $2,132.92 / $3,705.59	Professional		$1,417.99	$2,132.92	$3,705.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,071.14 / $1,345.62 / $1,345.62	Professional		$1,071.14	$1,345.62	$1,345.62