Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,613.08 / $3,270.10 / $22,024.00	Facility		$1,613.08	$3,270.10	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,156.86 / $1,613.08 / $3,450.36	Professional		$1,156.86	$1,613.08	$3,450.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $4,566.06 / $8,691.00	Facility		$55.00	$4,566.06	$8,691.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,788.58 / $2,924.27 / $10,806.60	Professional		$1,788.58	$2,924.27	$10,806.60
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 $1,289.08 / $2,244.04 / $3,798.96	Professional		$1,289.08	$2,244.04	$3,798.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $2,313.62 / $3,106.28	Facility		$1,183.00	$2,313.62	$3,106.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,220.83 / $2,317.00 / $3,182.18	Professional		$1,220.83	$2,317.00	$3,182.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $185.65 / $1,273.75 / $2,778.35	Professional		$185.65	$1,273.75	$2,778.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,630.23 / $2,223.06 / $2,497.09	Facility		$1,630.23	$2,223.06	$2,497.09
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,676.10 / $1,676.10 / $1,703.24	Facility		$1,676.10	$1,676.10	$1,703.24
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,915.45 / $2,709.53 / $3,380.76	Professional		$1,915.45	$2,709.53	$3,380.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $9,190.68 / $9,190.68 / $12,457.78	Facility		$9,190.68	$9,190.68	$12,457.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,709.40 / $2,450.13 / $3,279.59	Professional		$1,709.40	$2,450.13	$3,279.59
United Facility/Professional Facility Modifier Low / Median / High Price $702.00 / $1,323.00 / $5,793.00	Facility		$702.00	$1,323.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,488.76 / $2,014.08 / $3,599.37	Professional		$1,488.76	$2,014.08	$3,599.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,033.32 / $1,033.32 / $1,344.17	Professional		$1,033.32	$1,033.32	$1,344.17