Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,289.60 / $2,927.41 / $3,056.38	Facility		$1,289.60	$2,927.41	$3,056.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,146.32 / $1,289.60 / $3,056.38	Professional		$1,146.32	$1,289.60	$3,056.38
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,673.31 / $4,126.64 / $9,247.12	Facility		$1,673.31	$4,126.64	$9,247.12
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,364.19 / $1,673.31 / $11,100.47	Professional		$1,364.19	$1,673.31	$11,100.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,108.41 / $1,108.41 / $1,108.41	Facility		$1,108.41	$1,108.41	$1,108.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $809.14 / $809.14 / $1,108.41	Professional		$809.14	$809.14	$1,108.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,153.35 / $1,932.07 / $5,001.56	Facility		$1,153.35	$1,932.07	$5,001.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,159.68 / $1,949.19 / $3,707.20	Professional		$1,159.68	$1,949.19	$3,707.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,318.46 / $1,464.96 / $1,611.45	Professional		$1,318.46	$1,464.96	$1,611.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,516.89 / $1,866.18 / $2,229.01	Facility		$1,516.89	$1,866.18	$2,229.01
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,719.87 / $1,910.97 / $2,229.01	Professional		$1,719.87	$1,910.97	$2,229.01
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,673.31 / $2,146.11 / $3,732.36	Facility		$1,673.31	$2,146.11	$3,732.36
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,818.89 / $1,866.18 / $1,866.18	Facility		$1,818.89	$1,866.18	$1,866.18
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,518.09 / $1,624.32 / $2,102.07	Professional		$1,518.09	$1,624.32	$2,102.07
United Facility/Professional Professional Modifier Low / Median / High Price $805.84 / $1,007.30 / $1,662.85	Professional		$805.84	$1,007.30	$1,662.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,054.77 / $1,054.77 / $1,069.65	Professional		$1,054.77	$1,054.77	$1,069.65