Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,312.06 / $4,500.00 / $18,711.00	Facility		$1,312.06	$4,500.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $653.12 / $1,312.06 / $2,349.39	Professional		$653.12	$1,312.06	$2,349.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,462.03 / $10,956.90 / $20,959.32	Facility		$1,462.03	$10,956.90	$20,959.32
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,201.81 / $2,140.57 / $7,391.25	Professional		$1,201.81	$2,140.57	$7,391.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $642.00 / $642.00 / $3,759.09	Facility		$642.00	$642.00	$3,759.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $793.28 / $1,285.42 / $2,734.93	Professional		$793.28	$1,285.42	$2,734.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $900.57 / $1,751.15 / $3,376.68	Facility		$900.57	$1,751.15	$3,376.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $900.57 / $1,675.81 / $2,787.60	Professional		$900.57	$1,675.81	$2,787.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.13 / $474.28 / $1,689.37	Professional		$116.13	$474.28	$1,689.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,037.31 / $1,470.65 / $1,731.95	Facility		$1,037.31	$1,470.65	$1,731.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,161.49 / $1,161.49 / $1,181.34	Facility		$1,161.49	$1,161.49	$1,181.34
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,217.90 / $1,951.68 / $2,348.69	Professional		$1,217.90	$1,951.68	$2,348.69
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,105.06 / $10,950.64 / $20,959.32	Facility		$7,105.06	$10,950.64	$20,959.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,184.57 / $1,699.38 / $2,238.61	Professional		$1,184.57	$1,699.38	$2,238.61
United Facility/Professional Facility Modifier Low / Median / High Price $1,771.00 / $13,013.21 / $21,573.23	Facility		$1,771.00	$13,013.21	$21,573.23
United Facility/Professional Professional Modifier Low / Median / High Price $902.05 / $1,178.32 / $2,259.71	Professional		$902.05	$1,178.32	$2,259.71