Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,599.56 / $1,602.64 / $3,790.96	Facility		$1,599.56	$1,602.64	$3,790.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $932.92 / $1,421.83 / $2,767.24	Professional		$932.92	$1,421.83	$2,767.24
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,075.48 / $4,513.68 / $9,309.60	Facility		$2,075.48	$4,513.68	$9,309.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,390.18 / $2,014.72 / $11,732.79	Professional		$1,390.18	$2,014.72	$11,732.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,186.93 / $1,186.93 / $1,186.93	Facility		$1,186.93	$1,186.93	$1,186.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $866.46 / $866.46 / $1,186.93	Professional		$866.46	$866.46	$1,186.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,127.03 / $2,251.75 / $5,129.06	Facility		$1,127.03	$2,251.75	$5,129.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,128.27 / $2,251.75 / $3,800.70	Professional		$1,128.27	$2,251.75	$3,800.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,635.36 / $1,817.07 / $1,998.77	Professional		$1,635.36	$1,817.07	$1,998.77
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,974.80 / $2,314.71 / $2,370.26	Facility		$1,974.80	$2,314.71	$2,370.26
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,687.90 / $1,882.97 / $1,882.97	Professional		$1,687.90	$1,882.97	$1,882.97
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,075.48 / $2,661.92 / $4,629.42	Facility		$2,075.48	$2,661.92	$4,629.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,256.05 / $2,314.71 / $2,314.71	Facility		$2,256.05	$2,314.71	$2,314.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,882.97 / $2,014.72 / $2,607.29	Professional		$1,882.97	$2,014.72	$2,607.29
United Facility/Professional Facility Modifier Low / Median / High Price $1,193.78 / $1,193.78 / $1,193.78	Facility		$1,193.78	$1,193.78	$1,193.78
United Facility/Professional Professional Modifier Low / Median / High Price $826.28 / $895.14 / $1,705.04	Professional		$826.28	$895.14	$1,705.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $614.08 / $614.08 / $1,095.47	Professional		$614.08	$614.08	$1,095.47