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 $1,240.50 / $1,659.17 / $3,810.30	Professional		$1,240.50	$1,659.17	$3,810.30
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 $1,907.49 / $3,103.69 / $11,567.93	Professional		$1,907.49	$3,103.69	$11,567.93
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 $1,379.56 / $2,403.51 / $3,991.04	Professional		$1,379.56	$2,403.51	$3,991.04
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,414.62 / $2,843.37 / $6,417.76	Facility		$1,414.62	$2,843.37	$6,417.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,283.45 / $2,769.50 / $5,526.27	Professional		$1,283.45	$2,769.50	$5,526.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $150.32 / $590.98 / $2,748.93	Professional		$150.32	$590.98	$2,748.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,931.70 / $2,569.31 / $2,667.64	Facility		$1,931.70	$2,569.31	$2,667.64
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,777.12 / $1,809.40 / $5,433.20	Facility		$1,777.12	$1,809.40	$5,433.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,032.08 / $2,903.02 / $3,604.82	Professional		$2,032.08	$2,903.02	$3,604.82
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 $1,812.43 / $2,607.26 / $3,441.48	Professional		$1,812.43	$2,607.26	$3,441.48
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 $1,600.04 / $2,253.90 / $3,794.89	Professional		$1,600.04	$2,253.90	$3,794.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,105.65 / $1,105.65 / $1,414.36	Professional		$1,105.65	$1,105.65	$1,414.36