Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,356.63 / $3,079.55 / $3,215.21	Facility		$1,356.63	$3,079.55	$3,215.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,181.88 / $1,356.63 / $3,215.21	Professional		$1,181.88	$1,356.63	$3,215.21
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,827.97 / $4,207.21 / $11,250.63	Facility		$1,827.97	$4,207.21	$11,250.63
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,523.95 / $1,976.26 / $13,778.13	Professional		$1,523.95	$1,976.26	$13,778.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,620.00 / $1,620.00 / $1,620.00	Facility		$1,620.00	$1,620.00	$1,620.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,182.59 / $1,182.59 / $1,620.00	Professional		$1,182.59	$1,182.59	$1,620.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,313.58 / $2,220.10 / $5,720.57	Facility		$1,313.58	$2,220.10	$5,720.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,315.02 / $2,236.07 / $4,429.60	Professional		$1,315.02	$2,236.07	$4,429.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,440.33 / $1,600.37 / $1,760.40	Professional		$1,440.33	$1,600.37	$1,760.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,657.09 / $2,038.67 / $2,363.76	Facility		$1,657.09	$2,038.67	$2,363.76
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,878.84 / $2,087.60 / $2,363.76	Professional		$1,878.84	$2,087.60	$2,363.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,827.97 / $2,344.46 / $4,077.34	Facility		$1,827.97	$2,344.46	$4,077.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,987.01 / $2,038.67 / $2,038.67	Facility		$1,987.01	$2,038.67	$2,038.67
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,658.41 / $1,774.46 / $2,296.36	Professional		$1,658.41	$1,774.46	$2,296.36
United Facility/Professional Facility Modifier Low / Median / High Price $2,783.46 / $3,340.15 / $3,340.15	Facility		$2,783.46	$3,340.15	$3,340.15
United Facility/Professional Professional Modifier Low / Median / High Price $1,041.48 / $1,562.22 / $1,987.01	Professional		$1,041.48	$1,562.22	$1,987.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,275.38 / $1,275.38 / $1,275.38	Professional		$1,275.38	$1,275.38	$1,275.38