Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,584.20 / $3,596.13 / $3,754.55	Facility		$1,584.20	$3,596.13	$3,754.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,218.90 / $1,584.20 / $3,754.55	Professional		$1,218.90	$1,584.20	$3,754.55
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,134.61 / $4,985.83 / $12,771.35	Facility		$2,134.61	$4,985.83	$12,771.35
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,779.59 / $2,275.27 / $15,761.88	Professional		$1,779.59	$2,275.27	$15,761.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,523.27 / $1,523.27 / $1,523.27	Facility		$1,523.27	$1,523.27	$1,523.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,111.99 / $1,111.99 / $1,523.27	Professional		$1,111.99	$1,111.99	$1,523.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,533.80 / $2,592.29 / $6,680.16	Facility		$1,533.80	$2,592.29	$6,680.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,535.49 / $2,611.56 / $5,172.70	Professional		$1,535.49	$2,611.56	$5,172.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,681.94 / $1,868.83 / $2,055.71	Professional		$1,681.94	$1,868.83	$2,055.71
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,935.05 / $2,380.65 / $2,437.79	Facility		$1,935.05	$2,380.65	$2,437.79
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,315.90 / $2,437.79 / $2,437.79	Professional		$2,315.90	$2,437.79	$2,437.79
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,134.61 / $2,737.75 / $4,761.30	Facility		$2,134.61	$2,737.75	$4,761.30
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,320.32 / $2,380.65 / $2,380.65	Facility		$2,320.32	$2,380.65	$2,380.65
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,936.61 / $2,072.12 / $2,681.57	Professional		$1,936.61	$2,072.12	$2,681.57
United Facility/Professional Facility Modifier Low / Median / High Price $1,624.58 / $1,624.58 / $1,624.58	Facility		$1,624.58	$1,624.58	$1,624.58
United Facility/Professional Professional Modifier Low / Median / High Price $1,216.18 / $1,832.01 / $2,320.32	Professional		$1,216.18	$1,832.01	$2,320.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $676.53 / $676.53 / $1,489.31	Professional		$676.53	$676.53	$1,489.31