Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,372.43 / $3,115.42 / $3,252.66	Facility		$1,372.43	$3,115.42	$3,252.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,093.74 / $1,372.43 / $3,252.66	Professional		$1,093.74	$1,372.43	$3,252.66
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,849.26 / $4,054.32 / $10,094.70	Facility		$1,849.26	$4,054.32	$10,094.70
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,503.93 / $1,848.18 / $11,655.70	Professional		$1,503.93	$1,848.18	$11,655.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,207.83 / $1,207.83 / $1,207.83	Facility		$1,207.83	$1,207.83	$1,207.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $881.72 / $881.72 / $1,207.83	Professional		$881.72	$881.72	$1,207.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,216.21 / $2,111.91 / $5,534.06	Facility		$1,216.21	$2,111.91	$5,534.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,217.55 / $2,137.59 / $4,101.09	Professional		$1,217.55	$2,137.59	$4,101.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $2,111.91 / $2,111.91	Professional		$60.00	$2,111.91	$2,111.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,676.38 / $2,062.41 / $2,187.48	Facility		$1,676.38	$2,062.41	$2,187.48
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,900.72 / $2,111.91 / $2,217.51	Professional		$1,900.72	$2,111.91	$2,217.51
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,849.26 / $2,371.77 / $4,124.82	Facility		$1,849.26	$2,371.77	$4,124.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,010.15 / $2,062.41 / $2,062.41	Facility		$2,010.15	$2,062.41	$2,062.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,677.72 / $1,795.12 / $2,323.10	Professional		$1,677.72	$1,795.12	$2,323.10
United Facility/Professional Facility Modifier Low / Median / High Price $1,055.55 / $1,055.55 / $1,055.55	Facility		$1,055.55	$1,055.55	$1,055.55
United Facility/Professional Professional Modifier Low / Median / High Price $964.33 / $1,446.50 / $1,839.83	Professional		$964.33	$1,446.50	$1,839.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,143.82 / $1,143.82 / $1,300.05	Professional		$1,143.82	$1,143.82	$1,300.05