Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $837.45 / $1,901.01 / $1,984.76	Facility		$837.45	$1,901.01	$1,984.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $644.35 / $837.45 / $1,984.76	Professional		$644.35	$837.45	$1,984.76
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,128.42 / $2,684.77 / $6,807.72	Facility		$1,128.42	$2,684.77	$6,807.72
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $937.59 / $1,128.42 / $8,505.34	Professional		$937.59	$1,128.42	$8,505.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $908.11 / $908.11 / $908.11	Facility		$908.11	$908.11	$908.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $662.92 / $662.92 / $908.11	Professional		$662.92	$662.92	$908.11
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $810.81 / $1,370.35 / $3,531.34	Facility		$810.81	$1,370.35	$3,531.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $811.70 / $1,380.45 / $2,734.88	Professional		$811.70	$1,380.45	$2,734.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $889.12 / $987.92 / $1,086.71	Professional		$889.12	$987.92	$1,086.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,022.94 / $1,258.48 / $1,288.69	Facility		$1,022.94	$1,258.48	$1,288.69
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,022.94 / $1,288.69 / $1,353.12	Professional		$1,022.94	$1,288.69	$1,353.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,128.42 / $1,447.25 / $2,516.96	Facility		$1,128.42	$1,447.25	$2,516.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,226.58 / $1,258.48 / $1,258.48	Facility		$1,226.58	$1,258.48	$1,258.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,023.75 / $1,095.39 / $1,417.56	Professional		$1,023.75	$1,095.39	$1,417.56
United Facility/Professional Facility Modifier Low / Median / High Price $1,718.25 / $2,061.90 / $2,061.90	Facility		$1,718.25	$2,061.90	$2,061.90
United Facility/Professional Professional Modifier Low / Median / High Price $642.91 / $922.34 / $1,226.58	Professional		$642.91	$922.34	$1,226.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $787.30 / $1,129.17 / $1,129.17	Professional		$787.30	$1,129.17	$1,129.17