Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,738.23 / $3,945.78 / $4,119.60	Facility		$1,738.23	$3,945.78	$4,119.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,081.81 / $1,738.23 / $4,119.60	Professional		$1,081.81	$1,738.23	$4,119.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,255.40 / $4,904.97 / $9,986.98	Facility		$2,255.40	$4,904.97	$9,986.98
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,448.85 / $2,189.38 / $12,749.91	Professional		$1,448.85	$2,189.38	$12,749.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,207.09 / $1,207.09 / $1,207.09	Facility		$1,207.09	$1,207.09	$1,207.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $881.18 / $881.18 / $1,222.81	Professional		$881.18	$881.18	$1,222.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,215.30 / $2,446.94 / $5,531.25	Facility		$1,215.30	$2,446.94	$5,531.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,216.64 / $2,446.94 / $4,099.43	Professional		$1,216.64	$2,446.94	$4,099.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,777.11 / $1,974.57 / $2,172.02	Professional		$1,777.11	$1,974.57	$2,172.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,886.53 / $2,217.55 / $2,575.73	Facility		$1,886.53	$2,217.55	$2,575.73
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,931.80 / $2,575.73 / $2,575.73	Professional		$1,931.80	$2,575.73	$2,575.73
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,255.40 / $2,892.68 / $5,030.74	Facility		$2,255.40	$2,892.68	$5,030.74
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,451.62 / $2,515.37 / $2,515.37	Facility		$2,451.62	$2,515.37	$2,515.37
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,046.19 / $2,189.38 / $2,833.31	Professional		$2,046.19	$2,189.38	$2,833.31
United Facility/Professional Professional Modifier Low / Median / High Price $898.20 / $963.76 / $1,838.72	Professional		$898.20	$963.76	$1,838.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,047.58 / $1,047.58 / $1,148.64	Professional		$1,047.58	$1,047.58	$1,148.64