Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $808.65 / $1,835.64 / $1,916.50	Facility		$808.65	$1,835.64	$1,916.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $580.09 / $808.65 / $1,916.50	Professional		$580.09	$808.65	$1,916.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,049.24 / $2,300.11 / $5,476.21	Facility		$1,049.24	$2,300.11	$5,476.21
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $838.78 / $1,040.03 / $6,629.62	Professional		$838.78	$1,040.03	$6,629.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $732.96 / $732.96 / $732.96	Facility		$732.96	$732.96	$732.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $535.05 / $535.05 / $732.96	Professional		$535.05	$535.05	$732.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $651.55 / $1,198.25 / $2,966.25	Facility		$651.55	$1,198.25	$2,966.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $652.27 / $1,193.05 / $2,197.84	Professional		$652.27	$1,193.05	$2,197.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $826.74 / $918.60 / $1,010.46	Professional		$826.74	$918.60	$1,010.46
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $951.15 / $1,078.43 / $1,198.25	Facility		$951.15	$1,078.43	$1,198.25
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,018.51 / $1,078.43 / $1,198.25	Professional		$1,018.51	$1,078.43	$1,198.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,049.24 / $1,345.70 / $2,340.34	Facility		$1,049.24	$1,345.70	$2,340.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,140.52 / $1,170.17 / $1,170.17	Facility		$1,140.52	$1,170.17	$1,170.17
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $951.92 / $1,018.51 / $1,318.08	Professional		$951.92	$1,018.51	$1,318.08
United Facility/Professional Facility Modifier Low / Median / High Price $1,381.17 / $1,657.40 / $1,657.40	Facility		$1,381.17	$1,657.40	$1,657.40
United Facility/Professional Professional Modifier Low / Median / High Price $477.81 / $517.63 / $985.97	Professional		$477.81	$517.63	$985.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $624.49 / $624.49 / $656.91	Professional		$624.49	$624.49	$656.91