Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,259.85 / $2,859.88 / $2,985.87	Facility		$1,259.85	$2,859.88	$2,985.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,025.91 / $1,259.85 / $2,985.87	Professional		$1,025.91	$1,259.85	$2,985.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,697.59 / $4,086.63 / $9,671.83	Facility		$1,697.59	$4,086.63	$9,671.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,415.25 / $1,862.65 / $11,676.10	Professional		$1,415.25	$1,862.65	$11,676.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,573.58 / $1,573.58 / $1,573.58	Facility		$1,573.58	$1,573.58	$1,573.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,148.71 / $1,148.71 / $1,573.58	Professional		$1,148.71	$1,148.71	$1,573.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,147.96 / $1,954.24 / $5,223.75	Facility		$1,147.96	$1,954.24	$5,223.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,149.22 / $1,977.47 / $3,871.04	Professional		$1,149.22	$1,977.47	$3,871.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,337.59 / $1,486.22 / $1,634.84	Professional		$1,337.59	$1,486.22	$1,634.84
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,538.90 / $1,893.26 / $2,051.81	Facility		$1,538.90	$1,893.26	$2,051.81
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,647.90 / $1,938.70 / $2,051.81	Professional		$1,647.90	$1,938.70	$2,051.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,697.59 / $2,177.25 / $3,786.52	Facility		$1,697.59	$2,177.25	$3,786.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,845.28 / $1,893.26 / $1,893.26	Facility		$1,845.28	$1,893.26	$1,893.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,540.12 / $1,647.90 / $2,132.57	Professional		$1,540.12	$1,647.90	$2,132.57
United Facility/Professional Facility Modifier Low / Median / High Price $1,261.08 / $1,261.08 / $1,261.08	Facility		$1,261.08	$1,261.08	$1,261.08
United Facility/Professional Professional Modifier Low / Median / High Price $910.17 / $1,365.26 / $1,736.48	Professional		$910.17	$1,365.26	$1,736.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $785.81 / $785.81 / $1,114.58	Professional		$785.81	$785.81	$1,114.58