Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,179.64 / $2,272.41 / $2,677.78	Facility		$1,179.64	$2,272.41	$2,677.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $886.43 / $1,179.64 / $2,040.78	Professional		$886.43	$1,179.64	$2,040.78
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,530.62 / $3,635.67 / $8,339.85	Facility		$1,530.62	$3,635.67	$8,339.85
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,244.79 / $1,529.72 / $9,016.74	Professional		$1,244.79	$1,529.72	$9,016.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,162.20 / $1,162.20 / $1,433.06	Facility		$1,162.20	$1,162.20	$1,433.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $848.41 / $848.41 / $1,433.06	Professional		$848.41	$848.41	$1,433.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,056.11 / $1,768.93 / $4,580.62	Facility		$1,056.11	$1,768.93	$4,580.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,061.76 / $1,782.97 / $3,395.23	Professional		$1,061.76	$1,782.97	$3,395.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,206.03 / $1,340.04 / $1,474.04	Professional		$1,206.03	$1,340.04	$1,474.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,387.53 / $1,707.04 / $1,810.59	Facility		$1,387.53	$1,707.04	$1,810.59
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,573.21 / $1,748.01 / $1,922.81	Professional		$1,573.21	$1,748.01	$1,922.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,530.62 / $1,963.10 / $3,414.08	Facility		$1,530.62	$1,963.10	$3,414.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,663.78 / $1,707.04 / $1,707.04	Facility		$1,663.78	$1,707.04	$1,707.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,388.64 / $1,485.81 / $1,922.81	Professional		$1,388.64	$1,485.81	$1,922.81
United Facility/Professional Professional Modifier Low / Median / High Price $737.98 / $798.17 / $1,522.80	Professional		$737.98	$798.17	$1,522.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $586.17 / $586.17 / $968.81	Professional		$586.17	$586.17	$968.81