Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,328.23 / $3,015.08 / $3,147.90	Facility		$1,328.23	$3,015.08	$3,147.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,130.30 / $1,328.23 / $3,147.90	Professional		$1,130.30	$1,328.23	$3,147.90
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,789.70 / $4,087.79 / $10,228.89	Facility		$1,789.70	$4,087.79	$10,228.89
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,451.16 / $1,788.65 / $12,164.54	Professional		$1,451.16	$1,788.65	$12,164.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,367.82 / $1,367.82 / $1,367.82	Facility		$1,367.82	$1,367.82	$1,367.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $998.51 / $998.51 / $1,367.82	Professional		$998.51	$998.51	$1,367.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,285.83 / $2,173.19 / $5,600.78	Facility		$1,285.83	$2,173.19	$5,600.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,287.24 / $2,189.66 / $4,336.92	Professional		$1,287.24	$2,189.66	$4,336.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,410.17 / $1,566.86 / $1,723.54	Professional		$1,410.17	$1,566.86	$1,723.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,839.50 / $2,043.89 / $2,260.59	Facility		$1,839.50	$2,043.89	$2,260.59
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,623.69 / $1,623.69 / $1,623.69	Professional		$1,623.69	$1,623.69	$1,623.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,789.70 / $2,295.39 / $3,991.98	Facility		$1,789.70	$2,295.39	$3,991.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,945.41 / $1,995.99 / $1,995.99	Facility		$1,945.41	$1,995.99	$1,995.99
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,623.69 / $1,737.31 / $2,248.28	Professional		$1,623.69	$1,737.31	$2,248.28
United Facility/Professional Facility Modifier Low / Median / High Price $16.29 / $1,019.68 / $1,347.44	Facility		$16.29	$1,019.68	$1,347.44
United Facility/Professional Professional Modifier Low / Median / High Price $1,019.68 / $1,529.51 / $1,945.41	Professional		$1,019.68	$1,529.51	$1,945.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $483.98 / $483.98 / $1,242.91	Professional		$483.98	$483.98	$1,242.91