Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,359.97 / $3,087.13 / $3,223.13	Facility		$1,359.97	$3,087.13	$3,223.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,168.90 / $1,359.97 / $3,223.13	Professional		$1,168.90	$1,359.97	$3,223.13
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,764.61 / $4,191.35 / $9,614.69	Facility		$1,764.61	$4,191.35	$9,614.69
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,410.66 / $1,753.25 / $10,394.85	Professional		$1,410.66	$1,753.25	$10,394.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,335.63 / $1,335.63 / $1,335.63	Facility		$1,335.63	$1,335.63	$1,335.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $975.01 / $975.01 / $1,335.63	Professional		$975.01	$975.01	$1,335.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,224.00 / $2,090.23 / $5,522.23	Facility		$1,224.00	$2,090.23	$5,522.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,293.32 / $2,124.38 / $3,914.07	Professional		$1,293.32	$2,124.38	$3,914.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,390.40 / $1,544.89 / $1,699.37	Professional		$1,390.40	$1,544.89	$1,699.37
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,599.64 / $1,968.00 / $2,087.32	Facility		$1,599.64	$1,968.00	$2,087.32
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,600.92 / $2,015.23 / $2,216.75	Professional		$1,600.92	$2,015.23	$2,216.75
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,764.61 / $2,263.19 / $3,936.00	Facility		$1,764.61	$2,263.19	$3,936.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,918.13 / $1,968.00 / $1,968.00	Facility		$1,918.13	$1,968.00	$1,968.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,600.92 / $1,712.95 / $2,216.75	Professional		$1,600.92	$1,712.95	$2,216.75
United Facility/Professional Professional Modifier Low / Median / High Price $850.78 / $921.67 / $1,755.58	Professional		$850.78	$921.67	$1,755.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,123.35 / $1,712.95 / $1,712.95	Professional		$1,123.35	$1,712.95	$1,712.95