Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,911.50 / $4,339.10 / $4,530.25	Facility		$1,911.50	$4,339.10	$4,530.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,788.97 / $1,911.50 / $4,530.25	Professional		$1,788.97	$1,911.50	$4,530.25
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,575.62 / $5,882.87 / $15,444.00	Facility		$2,575.62	$5,882.87	$15,444.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,147.23 / $2,941.43 / $18,825.16	Professional		$2,147.23	$2,941.43	$18,825.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,902.78 / $1,902.78 / $1,902.78	Facility		$1,902.78	$1,902.78	$1,902.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,389.03 / $1,389.03 / $1,902.78	Professional		$1,389.03	$1,389.03	$1,902.78
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,850.48 / $3,127.52 / $8,060.26	Facility		$1,850.48	$3,127.52	$8,060.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,852.51 / $3,150.74 / $6,241.83	Professional		$1,852.51	$3,150.74	$6,241.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,029.43 / $2,254.92 / $2,480.42	Professional		$2,029.43	$2,254.92	$2,480.42
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,647.29 / $2,941.43 / $3,687.53	Facility		$2,647.29	$2,941.43	$3,687.53
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,575.62 / $3,303.36 / $5,744.98	Facility		$2,575.62	$3,303.36	$5,744.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,799.70 / $2,872.49 / $2,872.49	Facility		$2,799.70	$2,872.49	$2,872.49
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,336.71 / $2,500.21 / $3,235.57	Professional		$2,336.71	$2,500.21	$3,235.57
United Facility/Professional Professional Modifier Low / Median / High Price $1,467.45 / $2,105.23 / $2,799.70	Professional		$1,467.45	$2,105.23	$2,799.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,788.71 / $1,821.42 / $1,821.42	Professional		$1,788.71	$1,821.42	$1,821.42