Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,101.28 / $2,499.91 / $2,610.03	Facility		$1,101.28	$2,499.91	$2,610.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $912.29 / $1,101.28 / $2,610.03	Professional		$912.29	$1,101.28	$2,610.03
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,428.94 / $3,232.02 / $7,517.91	Facility		$1,428.94	$3,232.02	$7,517.91
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,118.04 / $1,466.58 / $9,193.29	Professional		$1,118.04	$1,466.58	$9,193.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $897.58 / $897.58 / $897.58	Facility		$897.58	$897.58	$897.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $655.23 / $655.23 / $1,007.79	Professional		$655.23	$655.23	$1,007.79
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $903.63 / $1,631.89 / $4,112.81	Facility		$903.63	$1,631.89	$4,112.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $904.62 / $1,631.89 / $3,047.68	Professional		$904.62	$1,631.89	$3,047.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,125.93 / $1,251.04 / $1,376.14	Professional		$1,125.93	$1,251.04	$1,376.14
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,295.35 / $1,593.64 / $1,631.89	Facility		$1,295.35	$1,593.64	$1,631.89
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,295.35 / $1,631.89 / $1,631.89	Professional		$1,295.35	$1,631.89	$1,631.89
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,428.94 / $1,832.69 / $3,187.28	Facility		$1,428.94	$1,832.69	$3,187.28
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,553.26 / $1,593.64 / $1,593.64	Facility		$1,553.26	$1,593.64	$1,593.64
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,296.41 / $1,387.11 / $1,795.08	Professional		$1,296.41	$1,387.11	$1,795.08
United Facility/Professional Facility Modifier Low / Median / High Price $957.27 / $957.27 / $957.27	Facility		$957.27	$957.27	$957.27
United Facility/Professional Professional Modifier Low / Median / High Price $662.59 / $717.80 / $1,367.23	Professional		$662.59	$717.80	$1,367.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $676.53 / $676.53 / $1,387.11	Professional		$676.53	$676.53	$1,387.11