Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,565.29 / $3,553.21 / $3,709.74	Facility		$1,565.29	$3,553.21	$3,709.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,135.74 / $1,565.29 / $3,709.74	Professional		$1,135.74	$1,565.29	$3,709.74
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,109.13 / $4,586.85 / $10,873.70	Facility		$2,109.13	$4,586.85	$10,873.70
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,626.68 / $2,109.13 / $13,267.87	Professional		$1,626.68	$2,109.13	$13,267.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,295.39 / $1,295.39 / $1,295.39	Facility		$1,295.39	$1,295.39	$1,295.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $945.63 / $945.63 / $1,295.39	Professional		$945.63	$945.63	$1,295.39
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,304.48 / $2,408.67 / $5,936.25	Facility		$1,304.48	$2,408.67	$5,936.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,305.91 / $2,388.14 / $4,398.99	Professional		$1,305.91	$2,388.14	$4,398.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,661.85 / $1,846.51 / $2,031.16	Professional		$1,661.85	$1,846.51	$2,031.16
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,911.95 / $2,271.46 / $2,408.67	Facility		$1,911.95	$2,271.46	$2,408.67
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,047.38 / $2,288.25 / $2,408.67	Professional		$2,047.38	$2,288.25	$2,408.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,109.13 / $2,705.06 / $4,704.46	Facility		$2,109.13	$2,705.06	$4,704.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,292.62 / $2,352.23 / $2,352.23	Facility		$2,292.62	$2,352.23	$2,352.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,913.48 / $2,047.38 / $2,649.55	Professional		$1,913.48	$2,047.38	$2,649.55
United Facility/Professional Professional Modifier Low / Median / High Price $1,034.25 / $1,551.38 / $1,973.21	Professional		$1,034.25	$1,551.38	$1,973.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $941.93 / $941.93 / $1,282.47	Professional		$941.93	$941.93	$1,282.47