Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,455.68 / $1,711.98 / $2,863.72	Facility		$1,455.68	$1,711.98	$2,863.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,389.51 / $1,689.97	Professional		$1,323.35	$1,389.51	$1,689.97
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,435.66 / $2,180.69 / $7,222.75	Facility		$1,435.66	$2,180.69	$7,222.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,455.69 / $6,148.12	Professional		$1,323.35	$1,455.69	$6,148.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,248.44 / $1,323.35 / $3,376.86	Facility		$1,248.44	$1,323.35	$3,376.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,323.35 / $1,622.97	Professional		$1,323.35	$1,323.35	$1,622.97
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $906.63 / $1,336.58 / $3,555.02	Facility		$906.63	$1,336.58	$3,555.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $906.63 / $1,336.58 / $3,088.23	Professional		$906.63	$1,336.58	$3,088.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $1,514.46 / $1,786.52	Professional		$75.00	$1,514.46	$1,786.52
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,323.35 / $1,558.62 / $3,026.80	Facility		$1,323.35	$1,558.62	$3,026.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,227.46 / $2,182.16 / $3,818.77	Facility		$1,227.46	$2,182.16	$3,818.77
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,471.34 / $1,773.50 / $3,205.43	Professional		$1,471.34	$1,773.50	$3,205.43
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,453.80 / $1,739.75 / $3,110.43	Facility		$1,453.80	$1,739.75	$3,110.43
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,455.69 / $1,588.01	Professional		$1,323.35	$1,455.69	$1,588.01
United Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,323.35 / $1,588.02	Professional		$1,323.35	$1,323.35	$1,588.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,323.35 / $1,392.52	Professional		$1,323.35	$1,323.35	$1,392.52