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 $1,300.51 / $1,720.05 / $3,905.64	Professional		$1,300.51	$1,720.05	$3,905.64
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 $1,964.05 / $3,155.05 / $11,999.48	Professional		$1,964.05	$3,155.05	$11,999.48
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 $1,401.05 / $2,449.19 / $4,140.03	Professional		$1,401.05	$2,449.19	$4,140.03
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,417.85 / $2,932.62 / $6,417.76	Facility		$1,417.85	$2,932.62	$6,417.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,368.50 / $2,824.57 / $5,526.27	Professional		$1,368.50	$2,824.57	$5,526.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $150.57 / $596.70 / $2,827.56	Professional		$150.57	$596.70	$2,827.56
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,113.37 / $2,665.38 / $2,761.74	Facility		$2,113.37	$2,665.38	$2,761.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,809.40 / $1,840.54 / $5,433.20	Facility		$1,809.40	$1,840.54	$5,433.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,105.55 / $3,006.62 / $3,739.07	Professional		$2,105.55	$3,006.62	$3,739.07
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 $1,877.11 / $2,702.04 / $3,569.65	Professional		$1,877.11	$2,702.04	$3,569.65
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 $1,671.60 / $2,253.90 / $3,940.21	Professional		$1,671.60	$2,253.90	$3,940.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,147.06 / $1,147.06 / $1,467.65	Professional		$1,147.06	$1,147.06	$1,467.65