Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $880.00 / $1,997.60 / $2,085.60	Facility		$880.00	$1,997.60	$2,085.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $635.05 / $880.00 / $2,085.60	Professional		$635.05	$880.00	$2,085.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,185.74 / $2,578.69 / $5,917.02	Facility		$1,185.74	$2,578.69	$5,917.02
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $881.34 / $1,178.10 / $6,703.04	Professional		$881.34	$1,178.10	$6,703.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $702.38 / $702.38 / $702.38	Facility		$702.38	$702.38	$702.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $512.74 / $512.74 / $702.38	Professional		$512.74	$512.74	$702.38
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $707.07 / $1,349.06 / $3,218.43	Facility		$707.07	$1,349.06	$3,218.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $707.84 / $1,297.43 / $2,384.85	Professional		$707.84	$1,297.43	$2,384.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $934.29 / $1,038.09 / $1,141.91	Professional		$934.29	$1,038.09	$1,141.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,074.89 / $1,270.10 / $1,354.15	Facility		$1,074.89	$1,270.10	$1,354.15
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,218.74 / $1,354.15 / $1,354.15	Professional		$1,218.74	$1,354.15	$1,354.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,185.74 / $1,520.77 / $2,644.82	Facility		$1,185.74	$1,520.77	$2,644.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,288.90 / $1,322.41 / $1,322.41	Facility		$1,288.90	$1,322.41	$1,322.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,075.75 / $1,151.03 / $1,489.57	Professional		$1,075.75	$1,151.03	$1,489.57
United Facility/Professional Professional Modifier Low / Median / High Price $560.78 / $844.74 / $1,069.89	Professional		$560.78	$844.74	$1,069.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $596.87 / $596.87 / $682.97	Professional		$596.87	$596.87	$682.97