Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,332.93 / $3,025.75 / $3,159.04	Facility		$1,332.93	$3,025.75	$3,159.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,093.34 / $1,332.93 / $3,159.04	Professional		$1,093.34	$1,332.93	$3,159.04
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,796.04 / $4,549.70 / $10,648.17	Facility		$1,796.04	$4,549.70	$10,648.17
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,497.32 / $1,914.39 / $14,383.26	Professional		$1,497.32	$1,914.39	$14,383.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,637.27 / $1,637.27 / $1,637.27	Facility		$1,637.27	$1,637.27	$1,637.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,195.21 / $1,195.21 / $1,637.27	Professional		$1,195.21	$1,195.21	$1,637.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,290.38 / $2,180.88 / $5,620.64	Facility		$1,290.38	$2,180.88	$5,620.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,291.79 / $2,197.25 / $4,352.64	Professional		$1,291.79	$2,197.25	$4,352.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,415.16 / $1,572.41 / $1,729.65	Professional		$1,415.16	$1,572.41	$1,729.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,628.15 / $2,003.06 / $2,186.69	Facility		$1,628.15	$2,003.06	$2,186.69
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,743.46 / $2,051.13 / $2,186.69	Professional		$1,743.46	$2,051.13	$2,186.69
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,796.04 / $2,303.52 / $4,006.12	Facility		$1,796.04	$2,303.52	$4,006.12
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,952.30 / $2,003.06 / $2,003.06	Facility		$1,952.30	$2,003.06	$2,003.06
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,629.44 / $1,743.46 / $2,256.23	Professional		$1,629.44	$1,743.46	$2,256.23
United Facility/Professional Facility Modifier Low / Median / High Price $1,366.91 / $1,366.91 / $1,366.91	Facility		$1,366.91	$1,366.91	$1,366.91
United Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,534.93 / $1,952.30	Professional		$1,023.29	$1,534.93	$1,952.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $676.53 / $676.53 / $1,253.11	Professional		$676.53	$676.53	$1,253.11