Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,489.38 / $5,128.00 / $18,800.00	Facility		$1,489.38	$5,128.00	$18,800.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $800.08 / $1,076.73 / $2,210.92	Professional		$800.08	$1,076.73	$2,210.92
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $6,079.47 / $9,879.37 / $25,560.89	Facility		$6,079.47	$9,879.37	$25,560.89
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,150.13 / $1,898.54 / $7,737.00	Professional		$1,150.13	$1,898.54	$7,737.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,353.44 / $2,353.44 / $3,920.80	Facility		$2,353.44	$2,353.44	$3,920.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,019.70 / $1,675.91 / $2,468.61	Professional		$1,019.70	$1,675.91	$2,468.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,008.84 / $1,875.62 / $9,036.82	Facility		$1,008.84	$1,875.62	$9,036.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,012.65 / $1,809.93 / $2,641.65	Professional		$1,012.65	$1,809.93	$2,641.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $100.45 / $987.28 / $1,929.25	Professional		$100.45	$987.28	$1,929.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,250.97 / $1,583.88 / $1,656.24	Facility		$1,250.97	$1,583.88	$1,656.24
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,084.03 / $1,117.36 / $1,470.05	Facility		$1,084.03	$1,117.36	$1,470.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,150.13 / $1,863.82 / $2,291.69	Professional		$1,150.13	$1,863.82	$2,291.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,208.83 / $9,873.73 / $18,898.13	Facility		$7,208.83	$9,873.73	$18,898.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,105.57 / $1,598.97 / $2,165.05	Professional		$1,105.57	$1,598.97	$2,165.05
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,297.00 / $12,835.00	Facility		$2,155.00	$3,297.00	$12,835.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,013.40 / $1,619.42 / $2,331.69	Professional		$1,013.40	$1,619.42	$2,331.69