Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,860.38 / $4,223.06 / $4,409.10	Facility		$1,860.38	$4,223.06	$4,409.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,253.21 / $1,860.38 / $4,409.10	Professional		$1,253.21	$1,860.38	$4,409.10
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,506.73 / $5,451.58 / $13,048.73	Facility		$2,506.73	$5,451.58	$13,048.73
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,948.21 / $2,490.62 / $15,680.88	Professional		$1,948.21	$2,490.62	$15,680.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,787.17 / $1,787.17 / $1,787.17	Facility		$1,787.17	$1,787.17	$1,787.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,304.63 / $1,304.63 / $2,033.58	Professional		$1,304.63	$1,304.63	$2,033.58
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,541.54 / $2,862.78 / $7,015.31	Facility		$1,541.54	$2,862.78	$7,015.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,543.23 / $2,822.49 / $5,200.01	Professional		$1,543.23	$2,822.49	$5,200.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,975.15 / $2,194.62 / $2,414.08	Professional		$1,975.15	$2,194.62	$2,414.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,272.40 / $2,576.50 / $2,862.78	Facility		$2,272.40	$2,576.50	$2,862.78
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,506.42 / $2,862.78 / $2,862.78	Professional		$2,506.42	$2,862.78	$2,862.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,506.73 / $3,215.03 / $5,591.36	Facility		$2,506.73	$3,215.03	$5,591.36
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,724.83 / $2,795.68 / $2,795.68	Facility		$2,724.83	$2,795.68	$2,795.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,274.21 / $2,433.36 / $3,149.06	Professional		$2,274.21	$2,433.36	$3,149.06
United Facility/Professional Facility Modifier Low / Median / High Price $1,448.21 / $1,448.21 / $1,448.21	Facility		$1,448.21	$1,448.21	$1,448.21
United Facility/Professional Professional Modifier Low / Median / High Price $1,222.33 / $1,702.37 / $2,332.08	Professional		$1,222.33	$1,702.37	$2,332.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,134.48 / $1,134.48 / $1,484.70	Professional		$1,134.48	$1,134.48	$1,484.70