Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $904.34 / $2,052.85 / $2,143.29	Facility		$904.34	$2,052.85	$2,143.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $750.43 / $904.34 / $2,143.29	Professional		$750.43	$904.34	$2,143.29
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,173.41 / $3,492.83 / $7,137.75	Facility		$1,173.41	$3,492.83	$7,137.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $968.19 / $1,173.41 / $11,041.83	Professional		$968.19	$1,173.41	$11,041.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $837.35 / $837.35 / $837.35	Facility		$837.35	$837.35	$837.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $611.27 / $611.27 / $848.24	Professional		$611.27	$611.27	$848.24
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $843.11 / $1,424.95 / $3,672.08	Facility		$843.11	$1,424.95	$3,672.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $844.04 / $1,435.30 / $2,844.11	Professional		$844.04	$1,435.30	$2,844.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $924.57 / $1,027.30 / $1,130.03	Professional		$924.57	$1,027.30	$1,130.03
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,063.71 / $1,308.66 / $1,340.06	Facility		$1,063.71	$1,308.66	$1,340.06
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,064.56 / $1,340.06 / $1,340.06	Professional		$1,064.56	$1,340.06	$1,340.06
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,173.41 / $1,504.96 / $2,617.32	Facility		$1,173.41	$1,504.96	$2,617.32
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,275.49 / $1,308.66 / $1,308.66	Facility		$1,275.49	$1,308.66	$1,308.66
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,064.56 / $1,139.05 / $1,474.07	Professional		$1,064.56	$1,139.05	$1,474.07
United Facility/Professional Facility Modifier Low / Median / High Price $10.68 / $662.58 / $668.54	Facility		$10.68	$662.58	$668.54
United Facility/Professional Professional Modifier Low / Median / High Price $618.12 / $668.54 / $1,275.49	Professional		$618.12	$668.54	$1,275.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $804.84 / $879.48 / $879.48	Professional		$804.84	$879.48	$879.48