Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,470.88 / $2,522.89 / $22,024.00	Facility		$1,470.88	$2,522.89	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,003.78 / $1,470.88 / $3,208.94	Professional		$1,003.78	$1,470.88	$3,208.94
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,668.05 / $5,471.61 / $12,100.72	Facility		$1,668.05	$5,471.61	$12,100.72
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,716.96 / $2,782.42 / $11,033.78	Professional		$1,716.96	$2,782.42	$11,033.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $765.00 / $870.49	Facility		$714.97	$765.00	$870.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,099.49 / $2,091.69 / $3,609.13	Professional		$1,099.49	$2,091.69	$3,609.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $978.82 / $1,793.31 / $3,001.62	Facility		$978.82	$1,793.31	$3,001.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,010.40 / $1,751.27 / $2,864.38	Professional		$1,010.40	$1,751.27	$2,864.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $205.92 / $1,202.26 / $2,637.62	Professional		$205.92	$1,202.26	$2,637.62
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,280.57 / $2,007.50 / $2,445.50	Facility		$1,280.57	$2,007.50	$2,445.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,609.96 / $1,609.96 / $1,668.05	Facility		$1,609.96	$1,609.96	$1,668.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,856.51 / $2,653.55 / $3,310.92	Professional		$1,856.51	$2,653.55	$3,310.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,913.81 / $5,468.48 / $10,466.57	Facility		$3,913.81	$5,468.48	$10,466.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,641.95 / $2,374.25 / $3,160.90	Professional		$1,641.95	$2,374.25	$3,160.90
United Facility/Professional Facility Modifier Low / Median / High Price $1,436.00 / $6,857.00 / $11,171.47	Facility		$1,436.00	$6,857.00	$11,171.47
United Facility/Professional Professional Modifier Low / Median / High Price $1,268.81 / $1,987.69 / $3,433.29	Professional		$1,268.81	$1,987.69	$3,433.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,012.89 / $1,012.89 / $1,279.16	Professional		$1,012.89	$1,012.89	$1,279.16