Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $4,130.72 / $4,312.68	Facility		$1,819.70	$4,130.72	$4,312.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,284.88 / $1,819.70 / $4,130.72	Professional		$1,284.88	$1,819.70	$4,130.72
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,361.11 / $5,134.85 / $11,140.65	Facility		$2,361.11	$5,134.85	$11,140.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,632.53 / $2,291.98 / $13,377.22	Professional		$1,632.53	$2,291.98	$13,377.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,306.07 / $1,306.07 / $1,306.07	Facility		$1,306.07	$1,306.07	$1,306.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $953.43 / $953.43 / $1,413.94	Professional		$953.43	$953.43	$1,413.94
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,314.95 / $2,561.64 / $5,985.00	Facility		$1,314.95	$2,561.64	$5,985.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,316.39 / $2,561.64 / $4,435.39	Professional		$1,316.39	$2,561.64	$4,435.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,860.42 / $2,067.14 / $2,273.85	Professional		$1,860.42	$2,067.14	$2,273.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,140.39 / $2,426.81 / $2,696.46	Facility		$2,140.39	$2,426.81	$2,696.46
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,142.11 / $2,561.64 / $2,696.46	Professional		$2,142.11	$2,561.64	$2,696.46
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,361.11 / $3,028.25 / $5,266.52	Facility		$2,361.11	$3,028.25	$5,266.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,566.53 / $2,633.26 / $2,633.26	Facility		$2,566.53	$2,633.26	$2,633.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,142.11 / $2,291.98 / $2,966.11	Professional		$2,142.11	$2,291.98	$2,966.11
United Facility/Professional Professional Modifier Low / Median / High Price $964.13 / $1,124.82 / $1,989.47	Professional		$964.13	$1,124.82	$1,989.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,124.07 / $1,124.07 / $1,258.95	Professional		$1,124.07	$1,124.07	$1,258.95