Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,235.10 / $2,803.70 / $2,927.21	Facility		$1,235.10	$2,803.70	$2,927.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $768.69 / $1,235.10 / $2,927.21	Professional		$768.69	$1,235.10	$2,927.21
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,602.60 / $4,098.12 / $7,331.22	Facility		$1,602.60	$4,098.12	$7,331.22
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,061.35 / $1,555.69 / $12,955.37	Professional		$1,061.35	$1,555.69	$12,955.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $857.71 / $857.71 / $857.71	Facility		$857.71	$857.71	$857.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $626.13 / $626.13 / $868.88	Professional		$626.13	$626.13	$868.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $863.59 / $1,738.71 / $3,930.00	Facility		$863.59	$1,738.71	$3,930.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $864.53 / $1,738.71 / $2,913.62	Professional		$864.53	$1,738.71	$2,913.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,262.74 / $1,403.05 / $1,543.35	Professional		$1,262.74	$1,403.05	$1,543.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,340.49 / $1,575.71 / $1,830.22	Facility		$1,340.49	$1,575.71	$1,830.22
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,372.66 / $1,830.22 / $1,830.22	Professional		$1,372.66	$1,830.22	$1,830.22
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,602.60 / $2,055.42 / $3,574.64	Facility		$1,602.60	$2,055.42	$3,574.64
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,742.03 / $1,787.32 / $1,787.32	Facility		$1,742.03	$1,787.32	$1,787.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,453.94 / $1,555.69 / $2,013.24	Professional		$1,453.94	$1,555.69	$2,013.24
United Facility/Professional Professional Modifier Low / Median / High Price $633.16 / $684.80 / $1,306.52	Professional		$633.16	$684.80	$1,306.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $494.38 / $494.38 / $803.81	Professional		$494.38	$494.38	$803.81