Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,552.69 / $8,507.78 / $22,024.00	Facility		$1,552.69	$8,507.78	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,111.52 / $1,455.34 / $2,950.11	Professional		$1,111.52	$1,455.34	$2,950.11
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,031.87 / $11,522.14 / $25,481.74	Facility		$2,031.87	$11,522.14	$25,481.74
Asuris Northwest Health Facility/Professional Facility Modifier AS Low / Median / High Price $676.94 / $1,125.97 / $1,125.97	Facility	AS	$676.94	$1,125.97	$1,125.97
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,421.68 / $2,415.23 / $8,894.50	Professional		$1,421.68	$2,415.23	$8,894.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,431.00 / $1,431.00 / $4,960.67	Facility		$1,431.00	$1,431.00	$4,960.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,037.46 / $1,779.29 / $3,164.23	Professional		$1,037.46	$1,779.29	$3,164.23
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,489.00 / $2,317.96 / $4,350.34	Facility		$1,489.00	$2,317.96	$4,350.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,489.00 / $2,315.07 / $3,678.65	Professional		$1,489.00	$2,315.07	$3,678.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.13 / $590.82 / $2,037.59	Professional		$116.13	$590.82	$2,037.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,616.02 / $2,003.97 / $2,689.70	Facility		$1,616.02	$2,003.97	$2,689.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,355.83 / $1,355.83 / $1,611.36	Facility		$1,355.83	$1,355.83	$1,611.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,443.19 / $2,312.38 / $2,782.98	Professional		$1,443.19	$2,312.38	$2,782.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,407.53 / $11,522.14 / $22,040.55	Facility		$8,407.53	$11,522.14	$22,040.55
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,382.77 / $2,016.91 / $2,992.78	Professional		$1,382.77	$2,016.91	$2,992.78
United Facility/Professional Facility Modifier Low / Median / High Price $2,263.00 / $2,912.00 / $16,315.00	Facility		$2,263.00	$2,912.00	$16,315.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,324.81 / $1,788.50 / $2,914.56	Professional		$1,324.81	$1,788.50	$2,914.56