Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,213.47 / $2,754.58 / $2,875.92	Facility		$1,213.47	$2,754.58	$2,875.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,043.01 / $1,213.47 / $2,875.92	Professional		$1,043.01	$1,213.47	$2,875.92
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,574.51 / $3,739.91 / $8,579.00	Facility		$1,574.51	$3,739.91	$8,579.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,280.49 / $1,564.37 / $9,275.29	Professional		$1,280.49	$1,564.37	$9,275.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,191.78 / $1,191.78 / $1,191.78	Facility		$1,191.78	$1,191.78	$1,191.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $870.00 / $870.00 / $1,191.78	Professional		$870.00	$870.00	$1,191.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,092.48 / $1,865.63 / $4,927.35	Facility		$1,092.48	$1,865.63	$4,927.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,154.44 / $1,896.26 / $3,492.87	Professional		$1,154.44	$1,896.26	$3,492.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,240.61 / $1,378.46 / $1,516.30	Professional		$1,240.61	$1,378.46	$1,516.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,427.33 / $1,755.99 / $1,862.51	Facility		$1,427.33	$1,755.99	$1,862.51
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,428.46 / $1,798.13 / $1,862.51	Professional		$1,428.46	$1,798.13	$1,862.51
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,574.51 / $2,019.39 / $3,511.98	Facility		$1,574.51	$2,019.39	$3,511.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,711.49 / $1,755.99 / $1,755.99	Facility		$1,711.49	$1,755.99	$1,755.99
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,428.46 / $1,528.41 / $1,977.94	Professional		$1,428.46	$1,528.41	$1,977.94
United Facility/Professional Professional Modifier Low / Median / High Price $759.14 / $854.39 / $1,566.48	Professional		$759.14	$854.39	$1,566.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,002.36 / $1,528.41 / $1,528.41	Professional		$1,002.36	$1,528.41	$1,528.41