Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,083.46 / $2,459.44 / $2,567.80	Facility		$1,083.46	$2,459.44	$2,567.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $798.83 / $1,083.46 / $2,567.80	Professional		$798.83	$1,083.46	$2,567.80
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,405.82 / $3,605.93 / $7,437.46	Facility		$1,405.82	$3,605.93	$7,437.46
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,117.88 / $1,393.05 / $8,383.06	Professional		$1,117.88	$1,393.05	$8,383.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $568.20 / $891.35 / $891.35	Facility		$568.20	$891.35	$891.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $650.69 / $650.69 / $1,165.85	Professional		$650.69	$650.69	$1,165.85
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $897.26 / $1,605.49 / $4,083.75	Facility		$897.26	$1,605.49	$4,083.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $898.24 / $1,605.49 / $3,026.99	Professional		$898.24	$1,605.49	$3,026.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $123.08 / $1,107.69 / $1,353.84	Professional		$123.08	$1,107.69	$1,353.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,274.40 / $1,444.94 / $1,605.49	Facility		$1,274.40	$1,444.94	$1,605.49
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,426.48 / $1,605.49 / $1,605.49	Professional		$1,426.48	$1,605.49	$1,605.49
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,405.82 / $1,803.04 / $3,135.72	Facility		$1,405.82	$1,803.04	$3,135.72
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,528.13 / $1,567.86 / $1,567.86	Facility		$1,528.13	$1,567.86	$1,567.86
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,275.41 / $1,364.67 / $1,766.04	Professional		$1,275.41	$1,364.67	$1,766.04
United Facility/Professional Professional Modifier Low / Median / High Price $657.98 / $767.65 / $1,357.75	Professional		$657.98	$767.65	$1,357.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $952.34 / $952.34 / $1,364.67	Professional		$952.34	$952.34	$1,364.67