Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,393.65 / $3,163.59 / $3,302.95	Facility		$1,393.65	$3,163.59	$3,302.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,245.40 / $1,393.65 / $3,302.95	Professional		$1,245.40	$1,393.65	$3,302.95
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,877.85 / $4,083.87 / $9,793.70	Facility		$1,877.85	$4,083.87	$9,793.70
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,426.54 / $1,830.74 / $12,404.18	Professional		$1,426.54	$1,830.74	$12,404.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,167.30 / $1,167.30 / $1,167.30	Facility		$1,167.30	$1,167.30	$1,167.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $852.13 / $852.13 / $1,167.30	Professional		$852.13	$852.13	$1,167.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,175.26 / $2,144.55 / $5,348.43	Facility		$1,175.26	$2,144.55	$5,348.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,176.55 / $2,144.55 / $3,963.72	Professional		$1,176.55	$2,144.55	$3,963.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,479.61 / $1,644.02 / $1,808.42	Professional		$1,479.61	$1,644.02	$1,808.42
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,702.29 / $2,094.29 / $2,490.80	Facility		$1,702.29	$2,094.29	$2,490.80
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,703.65 / $2,144.55 / $2,490.80	Professional		$1,703.65	$2,144.55	$2,490.80
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,877.85 / $2,408.42 / $4,188.58	Facility		$1,877.85	$2,408.42	$4,188.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,041.22 / $2,094.29 / $2,094.29	Facility		$2,041.22	$2,094.29	$2,094.29
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,703.65 / $1,822.87 / $2,359.01	Professional		$1,703.65	$1,822.87	$2,359.01
United Facility/Professional Professional Modifier Low / Median / High Price $931.98 / $1,403.89 / $1,778.09	Professional		$931.98	$1,403.89	$1,778.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $428.30 / $428.30 / $1,131.33	Professional		$428.30	$428.30	$1,131.33