Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,727.94 / $5,125.00 / $22,024.00	Facility		$1,727.94	$5,125.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,129.91 / $1,655.99 / $3,318.76	Professional		$1,129.91	$1,655.99	$3,318.76
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,725.93 / $8,558.00 / $11,734.24	Facility		$1,725.93	$8,558.00	$11,734.24
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,836.95 / $3,017.71 / $11,253.08	Professional		$1,836.95	$3,017.71	$11,253.08
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 $1,269.84 / $2,246.73 / $3,797.11	Professional		$1,269.84	$2,246.73	$3,797.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,196.91 / $2,450.46 / $3,190.75	Facility		$1,196.91	$2,450.46	$3,190.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,196.91 / $2,450.46 / $3,211.18	Professional		$1,196.91	$2,450.46	$3,211.18
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 $1,805.65 / $2,430.60 / $2,559.40	Facility		$1,805.65	$2,430.60	$2,559.40
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,725.93 / $1,725.93 / $1,745.74	Facility		$1,725.93	$1,725.93	$1,745.74
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,827.06 / $2,894.46 / $3,493.59	Professional		$1,827.06	$2,894.46	$3,493.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,038.35 / $2,511.27 / $3,295.65	Professional		$2,038.35	$2,511.27	$3,295.65
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $1,120.00 / $5,793.00	Facility		$650.00	$1,120.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,415.12 / $2,234.41 / $3,740.77	Professional		$1,415.12	$2,234.41	$3,740.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,059.28 / $1,328.65 / $1,328.65	Professional		$1,059.28	$1,328.65	$1,328.65