Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $823.38 / $1,869.07 / $1,951.41	Facility		$823.38	$1,869.07	$1,951.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $656.17 / $823.38 / $1,951.41	Professional		$656.17	$823.38	$1,951.41
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,109.46 / $2,412.81 / $6,045.06	Facility		$1,109.46	$2,412.81	$6,045.06
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $902.27 / $1,108.82 / $6,535.45	Professional		$902.27	$1,108.82	$6,535.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.63 / $724.63 / $724.63	Facility		$724.63	$724.63	$724.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $528.98 / $528.98 / $724.63	Professional		$528.98	$528.98	$724.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $729.82 / $1,267.04 / $3,319.68	Facility		$729.82	$1,267.04	$3,319.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $730.62 / $1,282.71 / $2,460.98	Professional		$730.62	$1,282.71	$2,460.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $874.18 / $971.32 / $1,068.45	Professional		$874.18	$971.32	$1,068.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,140.33 / $1,267.04 / $1,312.34	Facility		$1,140.33	$1,267.04	$1,312.34
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,006.55 / $1,006.55 / $1,006.55	Professional		$1,006.55	$1,006.55	$1,006.55
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,109.46 / $1,422.94 / $2,474.67	Facility		$1,109.46	$1,422.94	$2,474.67
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,205.98 / $1,237.33 / $1,237.33	Facility		$1,205.98	$1,237.33	$1,237.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,006.55 / $1,076.98 / $1,393.74	Professional		$1,006.55	$1,076.98	$1,393.74
United Facility/Professional Professional Modifier Low / Median / High Price $578.54 / $764.50 / $1,103.78	Professional		$578.54	$764.50	$1,103.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $779.93 / $779.93 / $779.93	Professional		$779.93	$779.93	$779.93