Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,196.15 / $2,715.26 / $2,834.88	Facility		$1,196.15	$2,715.26	$2,834.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,119.47 / $1,196.15 / $2,834.88	Professional		$1,119.47	$1,196.15	$2,834.88
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,611.73 / $4,491.67 / $9,898.48	Facility		$1,611.73	$4,491.67	$9,898.48
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,343.67 / $1,840.64 / $14,199.48	Professional		$1,343.67	$1,840.64	$14,199.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,408.48 / $1,408.48 / $1,408.48	Facility		$1,408.48	$1,408.48	$1,408.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,028.19 / $1,028.19 / $1,408.48	Professional		$1,028.19	$1,028.19	$1,408.48
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,157.97 / $1,957.10 / $5,043.85	Facility		$1,157.97	$1,957.10	$5,043.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,159.24 / $1,971.96 / $3,905.80	Professional		$1,159.24	$1,971.96	$3,905.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,269.94 / $1,411.05 / $1,552.15	Professional		$1,269.94	$1,411.05	$1,552.15
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,656.58 / $1,840.64 / $2,454.19	Facility		$1,656.58	$1,840.64	$2,454.19
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,462.23 / $1,462.23 / $1,462.23	Professional		$1,462.23	$1,462.23	$1,462.23
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,611.73 / $2,067.13 / $3,595.00	Facility		$1,611.73	$2,067.13	$3,595.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,751.95 / $1,797.50 / $1,797.50	Facility		$1,751.95	$1,797.50	$1,797.50
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,462.23 / $1,564.54 / $2,024.70	Professional		$1,462.23	$1,564.54	$2,024.70
United Facility/Professional Professional Modifier Low / Median / High Price $918.28 / $1,317.39 / $1,751.95	Professional		$918.28	$1,317.39	$1,751.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $651.54 / $651.54 / $1,124.51	Professional		$651.54	$651.54	$1,124.51