Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,537.05 / $3,489.10 / $3,642.81	Facility		$1,537.05	$3,489.10	$3,642.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,290.31 / $1,537.05 / $3,642.81	Professional		$1,290.31	$1,537.05	$3,642.81
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,994.37 / $4,869.16 / $11,712.03	Facility		$1,994.37	$4,869.16	$11,712.03
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,645.59 / $2,250.13 / $14,576.83	Professional		$1,645.59	$2,250.13	$14,576.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,703.99 / $1,703.99 / $1,703.99	Facility		$1,703.99	$1,703.99	$1,703.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,243.91 / $1,243.91 / $1,703.99	Professional		$1,243.91	$1,243.91	$1,703.99
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,503.84 / $2,440.26 / $6,241.28	Facility		$1,503.84	$2,440.26	$6,241.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,511.52 / $2,450.40 / $4,833.42	Professional		$1,511.52	$2,450.40	$4,833.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,571.44 / $1,746.05 / $1,920.65	Professional		$1,571.44	$1,746.05	$1,920.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,807.93 / $2,224.25 / $2,304.13	Facility		$1,807.93	$2,224.25	$2,304.13
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,935.99 / $2,277.63 / $2,304.13	Professional		$1,935.99	$2,277.63	$2,304.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,994.37 / $2,557.89 / $4,448.50	Facility		$1,994.37	$2,557.89	$4,448.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,167.88 / $2,224.25 / $2,224.25	Facility		$2,167.88	$2,224.25	$2,224.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,809.38 / $1,935.99 / $2,505.39	Professional		$1,809.38	$1,935.99	$2,505.39
United Facility/Professional Facility Modifier Low / Median / High Price $1,520.62 / $1,520.62 / $1,520.62	Facility		$1,520.62	$1,520.62	$1,520.62
United Facility/Professional Professional Modifier Low / Median / High Price $1,050.58 / $1,136.29 / $2,167.88	Professional		$1,050.58	$1,136.29	$2,167.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,387.19 / $1,509.17 / $1,509.17	Professional		$1,387.19	$1,509.17	$1,509.17