Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,264.82 / $2,941.28 / $22,024.00	Facility		$1,264.82	$2,941.28	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $972.79 / $1,264.82 / $2,941.28	Professional		$972.79	$1,264.82	$2,941.28
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $4,566.06 / $7,699.03	Facility		$55.00	$4,566.06	$7,699.03
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,428.32 / $2,190.40 / $10,776.75	Professional		$1,428.32	$2,190.40	$10,776.75
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 $1,066.75 / $1,822.54 / $3,036.23	Professional		$1,066.75	$1,822.54	$3,036.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $981.52 / $1,884.59 / $2,517.90	Facility		$981.52	$1,884.59	$2,517.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $975.04 / $1,926.71 / $2,540.42	Professional		$975.04	$1,926.71	$2,540.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.20 / $466.65 / $2,086.69	Professional		$109.20	$466.65	$2,086.69
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,441.87 / $1,920.22 / $2,003.30	Facility		$1,441.87	$1,920.22	$2,003.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,340.88 / $1,366.43 / $5,433.20	Facility		$1,340.88	$1,366.43	$5,433.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,534.72 / $2,190.40 / $2,712.23	Professional		$1,534.72	$2,190.40	$2,712.23
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 $1,367.52 / $1,957.11 / $2,628.56	Professional		$1,367.52	$1,957.11	$2,628.56
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 $1,232.38 / $1,662.28 / $3,004.92	Professional		$1,232.38	$1,662.28	$3,004.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $823.23 / $823.23 / $1,066.07	Professional		$823.23	$823.23	$1,066.07