Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,203.42 / $1,222.21 / $2,770.34	Professional		$1,203.42	$1,222.21	$2,770.34
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $214.52 / $11,540.27 / $11,540.27	Facility		$214.52	$11,540.27	$11,540.27
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,576.95 / $1,965.62 / $2,761.56	Professional		$1,576.95	$1,965.62	$2,761.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,772.06 / $1,772.06 / $2,111.63	Facility		$1,772.06	$1,772.06	$2,111.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,506.25 / $1,772.06 / $2,111.63	Professional		$1,506.25	$1,772.06	$2,111.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,351.07 / $2,351.07 / $2,351.07	Facility		$2,351.07	$2,351.07	$2,351.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,351.07 / $2,351.07 / $2,351.07	Professional		$2,351.07	$2,351.07	$2,351.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,420.28 / $2,689.21 / $3,037.71	Professional		$2,420.28	$2,689.21	$3,037.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,351.07 / $2,406.83 / $2,761.56	Facility		$2,351.07	$2,406.83	$2,761.56
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,115.96 / $2,351.07 / $2,761.56	Professional		$2,115.96	$2,351.07	$2,761.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $214.52 / $2,145.23 / $2,145.23	Facility		$214.52	$2,145.23	$2,145.23
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,940.20 / $2,454.87 / $2,624.98	Professional		$1,940.20	$2,454.87	$2,624.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,282.59 / $2,282.59 / $2,282.59	Facility		$2,282.59	$2,282.59	$2,282.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $191.79 / $191.79 / $233.52	Professional		$191.79	$191.79	$233.52
United Facility/Professional Facility Modifier Low / Median / High Price $102.09 / $904.85 / $1,508.42	Facility		$102.09	$904.85	$1,508.42
United Facility/Professional Professional Modifier Low / Median / High Price $1,113.65 / $1,216.33 / $2,337.96	Professional		$1,113.65	$1,216.33	$2,337.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,874.42 / $1,874.42 / $1,874.42	Professional		$1,874.42	$1,874.42	$1,874.42