Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,264.64 / $2,870.73 / $3,794.78	Facility		$1,264.64	$2,870.73	$3,794.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $902.00 / $1,264.64 / $2,997.20	Professional		$902.00	$1,264.64	$2,997.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,640.92 / $3,568.62 / $8,399.94	Facility		$1,640.92	$3,568.62	$8,399.94
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,206.71 / $1,592.88 / $10,156.85	Professional		$1,206.71	$1,592.88	$10,156.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,006.48 / $1,006.48 / $1,006.48	Facility		$1,006.48	$1,006.48	$1,006.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $734.73 / $734.73 / $1,019.57	Professional		$734.73	$734.73	$1,019.57
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,013.28 / $1,873.98 / $4,612.50	Facility		$1,013.28	$1,873.98	$4,612.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,014.39 / $1,855.52 / $3,417.57	Professional		$1,014.39	$1,855.52	$3,417.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,292.94 / $1,436.60 / $1,580.26	Professional		$1,292.94	$1,436.60	$1,580.26
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,487.51 / $1,686.58 / $1,873.98	Facility		$1,487.51	$1,686.58	$1,873.98
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,610.72 / $1,873.98 / $1,873.98	Professional		$1,610.72	$1,873.98	$1,873.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,640.92 / $2,104.57 / $3,660.12	Facility		$1,640.92	$2,104.57	$3,660.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,783.68 / $1,830.06 / $1,830.06	Facility		$1,783.68	$1,830.06	$1,830.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,488.70 / $1,592.88 / $2,061.38	Professional		$1,488.70	$1,592.88	$2,061.38
United Facility/Professional Facility Modifier Low / Median / High Price $820.00 / $820.00 / $820.00	Facility		$820.00	$820.00	$820.00
United Facility/Professional Professional Modifier Low / Median / High Price $742.97 / $804.88 / $1,533.11	Professional		$742.97	$804.88	$1,533.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $624.49 / $624.49 / $943.22	Professional		$624.49	$624.49	$943.22