Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,116.62 / $22,024.00	Facility		$1,733.00	$5,116.62	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,129.75 / $1,703.95 / $3,237.50	Professional		$1,129.75	$1,703.95	$3,237.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $10,160.00 / $22,291.15 / $38,538.61	Facility		$10,160.00	$22,291.15	$38,538.61
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,779.05 / $2,985.19 / $11,140.58	Professional		$1,779.05	$2,985.19	$11,140.58
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 $1,254.91 / $2,225.42 / $3,761.08	Professional		$1,254.91	$2,225.42	$3,761.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,380.75 / $2,676.75 / $9,096.45	Facility		$1,380.75	$2,676.75	$9,096.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,194.65 / $2,533.61 / $5,289.86	Professional		$1,194.65	$2,533.61	$5,289.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.09 / $459.74 / $2,818.14	Professional		$109.09	$459.74	$2,818.14
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,772.79 / $2,409.32 / $2,533.94	Facility		$1,772.79	$2,409.32	$2,533.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,704.64 / $1,704.64 / $1,728.37	Facility		$1,704.64	$1,704.64	$1,728.37
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,806.24 / $2,863.27 / $3,455.94	Professional		$1,806.24	$2,863.27	$3,455.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $21,285.78 / $29,154.55 / $55,801.25	Facility		$21,285.78	$29,154.55	$55,801.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,013.21 / $2,486.28 / $3,275.21	Professional		$2,013.21	$2,486.28	$3,275.21
United Facility/Professional Facility Modifier Low / Median / High Price $2,100.00 / $7,585.00 / $24,236.00	Facility		$2,100.00	$7,585.00	$24,236.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,412.20 / $2,200.21 / $3,633.19	Professional		$1,412.20	$2,200.21	$3,633.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,049.89 / $1,318.76 / $1,318.76	Professional		$1,049.89	$1,318.76	$1,318.76