Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,351.11 / $3,067.02 / $3,202.13	Facility		$1,351.11	$3,067.02	$3,202.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,200.99 / $1,351.11 / $3,202.13	Professional		$1,200.99	$1,351.11	$3,202.13
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,753.11 / $4,456.58 / $10,402.94	Facility		$1,753.11	$4,456.58	$10,402.94
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,461.53 / $1,791.05 / $11,980.54	Professional		$1,461.53	$1,791.05	$11,980.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,304.10 / $1,304.10 / $1,304.10	Facility		$1,304.10	$1,304.10	$1,304.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $952.00 / $952.00 / $1,304.10	Professional		$952.00	$952.00	$1,304.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,321.84 / $2,144.92 / $5,486.24	Facility		$1,321.84	$2,144.92	$5,486.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,328.64 / $2,153.76 / $4,248.38	Professional		$1,328.64	$2,153.76	$4,248.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,381.33 / $1,534.82 / $1,688.30	Professional		$1,381.33	$1,534.82	$1,688.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,589.23 / $1,955.17 / $2,405.73	Facility		$1,589.23	$1,955.17	$2,405.73
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,590.49 / $2,002.10 / $2,405.73	Professional		$1,590.49	$2,002.10	$2,405.73
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,753.11 / $2,248.44 / $3,910.34	Facility		$1,753.11	$2,248.44	$3,910.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,905.63 / $1,955.17 / $1,955.17	Facility		$1,905.63	$1,955.17	$1,955.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,590.49 / $1,701.79 / $2,202.31	Professional		$1,590.49	$1,701.79	$2,202.31
United Facility/Professional Professional Modifier Low / Median / High Price $923.50 / $1,000.45 / $1,905.63	Professional		$923.50	$1,000.45	$1,905.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,229.38 / $1,229.38 / $1,247.18	Professional		$1,229.38	$1,229.38	$1,247.18