Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,183.65 / $2,686.89 / $2,805.25	Facility		$1,183.65	$2,686.89	$2,805.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $736.66 / $1,183.65 / $2,805.25	Professional		$736.66	$1,183.65	$2,805.25
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,535.82 / $4,093.45 / $7,008.49	Facility		$1,535.82	$4,093.45	$7,008.49
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $986.60 / $1,490.86 / $12,940.74	Professional		$986.60	$1,490.86	$12,940.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $830.86 / $830.86 / $830.86	Facility		$830.86	$830.86	$830.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $606.53 / $606.53 / $840.46	Professional		$606.53	$606.53	$840.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $827.64 / $1,666.25 / $3,766.87	Facility		$827.64	$1,666.25	$3,766.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $828.55 / $1,666.25 / $2,791.98	Professional		$828.55	$1,666.25	$2,791.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,210.13 / $1,344.59 / $1,479.04	Professional		$1,210.13	$1,344.59	$1,479.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,284.63 / $1,510.05 / $1,753.95	Facility		$1,284.63	$1,510.05	$1,753.95
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,315.46 / $1,578.56 / $1,753.95	Professional		$1,315.46	$1,578.56	$1,753.95
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,535.82 / $1,969.77 / $3,425.68	Facility		$1,535.82	$1,969.77	$3,425.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,669.44 / $1,712.84 / $1,712.84	Facility		$1,669.44	$1,712.84	$1,712.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,393.36 / $1,490.86 / $1,929.35	Professional		$1,393.36	$1,490.86	$1,929.35
United Facility/Professional Facility Modifier Low / Median / High Price $876.64 / $876.64 / $876.64	Facility		$876.64	$876.64	$876.64
United Facility/Professional Professional Modifier Low / Median / High Price $606.77 / $656.27 / $1,252.08	Professional		$606.77	$656.27	$1,252.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $495.43 / $495.43 / $792.54	Professional		$495.43	$495.43	$792.54