Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,128.00 / $20,680.40	Facility		$1,733.00	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,010.80 / $1,421.35 / $3,309.62	Professional		$1,010.80	$1,421.35	$3,309.62
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,433.20 / $18,458.89 / $36,111.08	Facility		$5,433.20	$18,458.89	$36,111.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,561.98 / $2,456.75 / $9,567.45	Professional		$1,561.98	$2,456.75	$9,567.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $7,318.13	Facility		$714.97	$870.49	$7,318.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,193.16 / $2,027.70 / $3,254.64	Professional		$1,193.16	$2,027.70	$3,254.64
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,148.83 / $2,415.44 / $6,417.76	Facility		$1,148.83	$2,415.44	$6,417.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,134.91 / $2,339.15 / $5,526.27	Professional		$1,134.91	$2,339.15	$5,526.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.28 / $500.91 / $2,244.07	Professional		$116.28	$500.91	$2,244.07
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,571.32 / $2,087.60 / $2,273.31	Facility		$1,571.32	$2,087.60	$2,273.31
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,433.75 / $1,486.62 / $5,433.20	Facility		$1,433.75	$1,486.62	$5,433.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,639.54 / $2,364.92 / $2,950.80	Professional		$1,639.54	$2,364.92	$2,950.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,241.40 / $18,867.00 / $36,111.08	Facility		$12,241.40	$18,867.00	$36,111.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,462.23 / $2,112.76 / $2,817.10	Professional		$1,462.23	$2,112.76	$2,817.10
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $4,016.00 / $16,315.00	Facility		$2,912.00	$4,016.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,294.29 / $1,755.05 / $3,031.45	Professional		$1,294.29	$1,755.05	$3,031.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $904.40 / $904.40 / $1,154.75	Professional		$904.40	$904.40	$1,154.75