Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,303.33 / $2,958.58 / $3,088.92	Facility		$1,303.33	$2,958.58	$3,088.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,158.52 / $1,303.33 / $3,088.92	Professional		$1,158.52	$1,303.33	$3,088.92
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,691.12 / $5,016.89 / $10,169.41	Facility		$1,691.12	$5,016.89	$10,169.41
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,371.23 / $1,680.24 / $12,823.90	Professional		$1,371.23	$1,680.24	$12,823.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,206.80 / $1,206.80 / $1,206.80	Facility		$1,206.80	$1,206.80	$1,206.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $880.96 / $880.96 / $1,206.80	Professional		$880.96	$880.96	$1,206.80
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,215.30 / $2,053.98 / $5,292.28	Facility		$1,215.30	$2,053.98	$5,292.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,216.64 / $2,068.98 / $4,098.60	Professional		$1,216.64	$2,068.98	$4,098.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,332.49 / $1,480.55 / $1,628.60	Professional		$1,332.49	$1,480.55	$1,628.60
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,533.03 / $1,886.05 / $2,575.08	Facility		$1,533.03	$1,886.05	$2,575.08
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,931.31 / $1,931.31 / $2,575.08	Professional		$1,931.31	$1,931.31	$2,575.08
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,691.12 / $2,168.96 / $3,772.10	Facility		$1,691.12	$2,168.96	$3,772.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,838.25 / $1,886.05 / $1,886.05	Facility		$1,838.25	$1,886.05	$1,886.05
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,534.25 / $1,641.61 / $2,124.44	Professional		$1,534.25	$1,641.61	$2,124.44
United Facility/Professional Professional Modifier Low / Median / High Price $890.84 / $965.08 / $1,838.25	Professional		$890.84	$965.08	$1,838.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $714.00 / $714.00 / $1,176.26	Professional		$714.00	$714.00	$1,176.26