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 $1,167.45 / $1,586.37 / $3,654.15	Professional		$1,167.45	$1,586.37	$3,654.15
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 $1,875.67 / $2,909.45 / $11,065.35	Professional		$1,875.67	$2,909.45	$11,065.35
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 $1,363.73 / $2,263.31 / $3,818.12	Professional		$1,363.73	$2,263.31	$3,818.12
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,358.98 / $2,751.01 / $6,417.76	Facility		$1,358.98	$2,751.01	$6,417.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,227.72 / $2,644.80 / $5,526.27	Professional		$1,227.72	$2,644.80	$5,526.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $150.32 / $579.56 / $2,613.00	Professional		$150.32	$579.56	$2,613.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,819.30 / $2,457.56 / $2,546.67	Facility		$1,819.30	$2,457.56	$2,546.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,697.39 / $1,737.06 / $5,433.20	Facility		$1,697.39	$1,737.06	$5,433.20
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,941.65 / $2,772.78 / $3,447.89	Professional		$1,941.65	$2,772.78	$3,447.89
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 $1,731.11 / $2,491.11 / $3,291.67	Professional		$1,731.11	$2,491.11	$3,291.67
United Facility/Professional Facility Modifier Low / Median / High Price $4,016.00 / $22,200.84 / $36,636.56	Facility		$4,016.00	$22,200.84	$36,636.56
United Facility/Professional Professional Modifier Low / Median / High Price $1,505.00 / $2,054.06 / $3,648.63	Professional		$1,505.00	$2,054.06	$3,648.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,057.60 / $1,057.60 / $1,353.73	Professional		$1,057.60	$1,057.60	$1,353.73