Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,698.34 / $3,855.23 / $4,025.07	Facility		$1,698.34	$3,855.23	$4,025.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,311.47 / $1,698.34 / $4,025.07	Professional		$1,311.47	$1,698.34	$4,025.07
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,203.66 / $4,792.42 / $10,013.70	Facility		$2,203.66	$4,792.42	$10,013.70
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,340.11 / $2,139.14 / $12,532.82	Professional		$1,340.11	$2,139.14	$12,532.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,179.41 / $1,179.41 / $1,179.41	Facility		$1,179.41	$1,179.41	$1,179.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $860.97 / $860.97 / $1,179.41	Professional		$860.97	$860.97	$1,179.41
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,187.55 / $2,390.80 / $5,404.68	Facility		$1,187.55	$2,390.80	$5,404.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,188.84 / $2,390.80 / $4,005.10	Professional		$1,188.84	$2,390.80	$4,005.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,736.35 / $1,929.28 / $2,122.20	Professional		$1,736.35	$1,929.28	$2,122.20
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,997.65 / $2,457.65 / $2,516.63	Facility		$1,997.65	$2,457.65	$2,516.63
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,139.14 / $2,516.63 / $2,516.63	Professional		$2,139.14	$2,516.63	$2,516.63
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,203.66 / $2,826.30 / $4,915.30	Facility		$2,203.66	$2,826.30	$4,915.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,395.37 / $2,457.65 / $2,457.65	Facility		$2,395.37	$2,457.65	$2,457.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,999.25 / $2,139.14 / $2,768.29	Professional		$1,999.25	$2,139.14	$2,768.29
United Facility/Professional Professional Modifier Low / Median / High Price $870.62 / $943.18 / $1,796.53	Professional		$870.62	$943.18	$1,796.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,092.84 / $1,092.84 / $1,137.16	Professional		$1,092.84	$1,092.84	$1,137.16