Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $4,011.00 / $18,711.00	Facility		$1,733.00	$4,011.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,116.67 / $1,474.35 / $3,322.71	Professional		$1,116.67	$1,474.35	$3,322.71
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,403.52 / $6,009.15 / $12,100.72	Facility		$3,403.52	$6,009.15	$12,100.72
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,688.19 / $2,703.12 / $10,289.48	Professional		$1,688.19	$2,703.12	$10,289.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $625.25 / $761.81 / $2,190.81	Facility		$625.25	$761.81	$2,190.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,178.70 / $2,099.40 / $3,551.27	Professional		$1,178.70	$2,099.40	$3,551.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,138.24 / $1,945.80 / $3,034.83	Facility		$1,138.24	$1,945.80	$3,034.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,130.50 / $1,958.12 / $2,977.24	Professional		$1,130.50	$1,958.12	$2,977.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $185.65 / $1,227.39 / $2,632.98	Professional		$185.65	$1,227.39	$2,632.98
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,645.42 / $2,233.55 / $2,367.78	Facility		$1,645.42	$2,233.55	$2,367.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,062.34 / $1,576.89 / $3,189.98	Facility		$1,062.34	$1,576.89	$3,189.98
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,803.95 / $2,575.94 / $3,205.69	Professional		$1,803.95	$2,575.94	$3,205.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,179.46 / $5,682.43 / $10,585.41	Facility		$4,179.46	$5,682.43	$10,585.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,608.22 / $2,298.80 / $3,060.44	Professional		$1,608.22	$2,298.80	$3,060.44
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,129.00 / $11,941.00	Facility		$2,155.00	$3,129.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,411.66 / $1,909.77 / $3,389.87	Professional		$1,411.66	$1,909.77	$3,389.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $982.80 / $982.80 / $1,259.52	Professional		$982.80	$982.80	$1,259.52