Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,102.54 / $4,772.77 / $4,983.02	Facility		$2,102.54	$4,772.77	$4,983.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,494.07 / $2,102.54 / $4,983.02	Professional		$1,494.07	$2,102.54	$4,983.02
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,833.03 / $6,161.16 / $14,469.30	Facility		$2,833.03	$6,161.16	$14,469.30
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,156.23 / $2,782.44 / $17,186.59	Professional		$2,156.23	$2,782.44	$17,186.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,084.13 / $2,084.13 / $2,084.13	Facility		$2,084.13	$2,084.13	$2,084.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,521.41 / $1,521.41 / $2,084.13	Professional		$1,521.41	$1,521.41	$2,084.13
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,733.09 / $3,235.40 / $7,887.18	Facility		$1,733.09	$3,235.40	$7,887.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,734.99 / $3,173.33 / $5,845.46	Professional		$1,734.99	$3,173.33	$5,845.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,232.25 / $2,480.28 / $2,728.30	Professional		$2,232.25	$2,480.28	$2,728.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,568.19 / $2,988.14 / $3,235.40	Facility		$2,568.19	$2,988.14	$3,235.40
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,911.86 / $3,235.40 / $3,558.94	Professional		$2,911.86	$3,235.40	$3,558.94
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,833.03 / $3,633.51 / $6,319.14	Facility		$2,833.03	$3,633.51	$6,319.14
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,079.50 / $3,159.57 / $3,159.57	Facility		$3,079.50	$3,159.57	$3,159.57
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,570.23 / $2,750.09 / $3,558.94	Professional		$2,570.23	$2,750.09	$3,558.94
United Facility/Professional Facility Modifier Low / Median / High Price $1,058.80 / $1,815.91 / $2,117.59	Facility		$1,058.80	$1,815.91	$2,117.59
United Facility/Professional Professional Modifier Low / Median / High Price $1,374.19 / $2,070.03 / $2,621.77	Professional		$1,374.19	$2,070.03	$2,621.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,488.88 / $1,488.88 / $1,722.19	Professional		$1,488.88	$1,488.88	$1,722.19