Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,501.24 / $3,407.81 / $3,557.94	Facility		$1,501.24	$3,407.81	$3,557.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,050.81 / $1,501.24 / $3,557.94	Professional		$1,050.81	$1,501.24	$3,557.94
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,947.90 / $4,236.22 / $9,934.14	Facility		$1,947.90	$4,236.22	$9,934.14
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,455.00 / $1,890.88 / $12,009.26	Professional		$1,455.00	$1,890.88	$12,009.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,172.51 / $1,172.51 / $1,172.51	Facility		$1,172.51	$1,172.51	$1,172.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $855.93 / $855.93 / $1,264.74	Professional		$855.93	$855.93	$1,264.74
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,180.72 / $2,224.56 / $5,372.81	Facility		$1,180.72	$2,224.56	$5,372.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,182.02 / $2,161.55 / $3,981.93	Professional		$1,182.02	$2,161.55	$3,981.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,534.82 / $1,705.36 / $1,875.89	Professional		$1,534.82	$1,705.36	$1,875.89
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,765.79 / $2,002.10 / $2,224.56	Facility		$1,765.79	$2,002.10	$2,224.56
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,876.44 / $2,224.56 / $2,224.56	Professional		$1,876.44	$2,224.56	$2,224.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,947.90 / $2,498.28 / $4,344.84	Facility		$1,947.90	$2,498.28	$4,344.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,117.37 / $2,172.42 / $2,172.42	Facility		$2,117.37	$2,172.42	$2,172.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,767.21 / $1,890.88 / $2,447.02	Professional		$1,767.21	$1,890.88	$2,447.02
United Facility/Professional Professional Modifier Low / Median / High Price $881.18 / $1,009.79 / $1,786.03	Professional		$881.18	$1,009.79	$1,786.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,130.53 / $1,144.89 / $1,144.89	Professional		$1,130.53	$1,144.89	$1,144.89