Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,292.09 / $2,933.07 / $3,062.28	Facility		$1,292.09	$2,933.07	$3,062.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,029.74 / $1,292.09 / $3,062.28	Professional		$1,029.74	$1,292.09	$3,062.28
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,741.02 / $5,036.41 / $9,502.08	Facility		$1,741.02	$5,036.41	$9,502.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,415.91 / $1,739.99 / $14,479.07	Professional		$1,415.91	$1,739.99	$14,479.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,317.79 / $1,317.79 / $1,317.79	Facility		$1,317.79	$1,317.79	$1,317.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $961.99 / $961.99 / $1,317.79	Professional		$961.99	$961.99	$1,317.79
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,144.78 / $1,988.29 / $5,210.62	Facility		$1,144.78	$1,988.29	$5,210.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,146.03 / $2,012.04 / $3,861.94	Professional		$1,146.03	$2,012.04	$3,861.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,371.81 / $1,524.24 / $1,676.66	Professional		$1,371.81	$1,524.24	$1,676.66
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,789.46 / $1,988.29 / $2,059.48	Facility		$1,789.46	$1,988.29	$2,059.48
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,741.02 / $2,232.94 / $3,883.38	Facility		$1,741.02	$2,232.94	$3,883.38
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,892.49 / $1,941.69 / $1,941.69	Facility		$1,892.49	$1,941.69	$1,941.69
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,579.52 / $1,690.05 / $2,187.12	Professional		$1,579.52	$1,690.05	$2,187.12
United Facility/Professional Professional Modifier Low / Median / High Price $907.89 / $1,361.84 / $1,732.13	Professional		$907.89	$1,361.84	$1,732.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,111.77 / $1,111.77 / $1,111.77	Professional		$1,111.77	$1,111.77	$1,111.77