Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,265.36 / $2,872.39 / $2,998.93	Facility		$1,265.36	$2,872.39	$2,998.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,116.32 / $1,265.36 / $2,998.93	Professional		$1,116.32	$1,265.36	$2,998.93
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,641.85 / $3,694.38 / $8,501.27	Facility		$1,641.85	$3,694.38	$8,501.27
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,226.53 / $1,612.53 / $9,927.28	Professional		$1,226.53	$1,612.53	$9,927.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,025.33 / $1,025.33 / $1,025.33	Facility		$1,025.33	$1,025.33	$1,025.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $748.49 / $748.49 / $1,025.33	Professional		$748.49	$748.49	$1,025.33
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,059.24 / $1,875.04 / $4,855.96	Facility		$1,059.24	$1,875.04	$4,855.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,064.64 / $1,875.04 / $3,404.33	Professional		$1,064.64	$1,875.04	$3,404.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,293.67 / $1,437.42 / $1,581.16	Professional		$1,293.67	$1,437.42	$1,581.16
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,488.36 / $1,831.09 / $1,993.43	Facility		$1,488.36	$1,831.09	$1,993.43
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,593.78 / $1,875.04 / $1,993.43	Professional		$1,593.78	$1,875.04	$1,993.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,641.85 / $2,105.75 / $3,662.18	Facility		$1,641.85	$2,105.75	$3,662.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,784.69 / $1,831.09 / $1,831.09	Facility		$1,784.69	$1,831.09	$1,831.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,489.55 / $1,593.78 / $2,062.54	Professional		$1,489.55	$1,593.78	$2,062.54
United Facility/Professional Professional Modifier Low / Median / High Price $739.96 / $801.62 / $1,526.89	Professional		$739.96	$801.62	$1,526.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $920.10 / $920.10 / $975.53	Professional		$920.10	$920.10	$975.53