Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,778.73 / $12,274.80 / $23,907.50	Facility		$1,778.73	$12,274.80	$23,907.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,255.67 / $1,604.90 / $3,511.64	Professional		$1,255.67	$1,604.90	$3,511.64
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 $1,633.05 / $2,760.31 / $10,464.70	Professional		$1,633.05	$2,760.31	$10,464.70
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 $1,262.61 / $2,046.20 / $3,619.82	Professional		$1,262.61	$2,046.20	$3,619.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,713.50 / $2,459.53 / $4,350.34	Facility		$1,713.50	$2,459.53	$4,350.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,713.50 / $2,459.53 / $4,010.33	Professional		$1,713.50	$2,459.53	$4,010.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $795.30 / $2,335.58	Professional		$139.21	$795.30	$2,335.58
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,933.27 / $2,309.10 / $2,973.05	Facility		$1,933.27	$2,309.10	$2,973.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,557.41 / $1,557.41 / $1,611.36	Facility		$1,557.41	$1,557.41	$1,611.36
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,654.87 / $2,653.26 / $3,191.18	Professional		$1,654.87	$2,653.26	$3,191.18
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 $1,588.36 / $2,312.73 / $3,171.48	Professional		$1,588.36	$2,312.73	$3,171.48
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 $1,456.41 / $2,027.51 / $3,312.66	Professional		$1,456.41	$2,027.51	$3,312.66