Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,389.16 / $3,153.39 / $3,292.31	Facility		$1,389.16	$3,153.39	$3,292.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,107.07 / $1,389.16 / $3,292.31	Professional		$1,107.07	$1,389.16	$3,292.31
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,871.81 / $4,070.74 / $10,198.75	Facility		$1,871.81	$4,070.74	$10,198.75
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,522.25 / $1,870.71 / $11,026.37	Professional		$1,522.25	$1,870.71	$11,026.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,222.54 / $1,222.54 / $1,222.54	Facility		$1,222.54	$1,222.54	$1,222.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $892.45 / $892.45 / $1,386.29	Professional		$892.45	$892.45	$1,386.29
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,230.77 / $2,137.66 / $5,601.56	Facility		$1,230.77	$2,137.66	$5,601.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,232.11 / $2,163.17 / $4,151.56	Professional		$1,232.11	$2,163.17	$4,151.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,474.86 / $1,638.74 / $1,802.61	Professional		$1,474.86	$1,638.74	$1,802.61
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,696.81 / $2,087.56 / $2,214.13	Facility		$1,696.81	$2,087.56	$2,214.13
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,923.89 / $2,137.66 / $2,214.13	Professional		$1,923.89	$2,137.66	$2,214.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,871.81 / $2,400.69 / $4,175.12	Facility		$1,871.81	$2,400.69	$4,175.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,034.66 / $2,087.56 / $2,087.56	Facility		$2,034.66	$2,087.56	$2,087.56
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,698.18 / $1,817.01 / $2,351.42	Professional		$1,698.18	$1,817.01	$2,351.42
United Facility/Professional Facility Modifier Low / Median / High Price $2,608.67 / $3,130.40 / $3,130.40	Facility		$2,608.67	$3,130.40	$3,130.40
United Facility/Professional Professional Modifier Low / Median / High Price $976.08 / $1,464.12 / $1,862.23	Professional		$976.08	$1,464.12	$1,862.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.33 / $42.33 / $1,315.88	Professional		$42.33	$42.33	$1,315.88