Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,255.61 / $2,850.26 / $2,975.82	Facility		$1,255.61	$2,850.26	$2,975.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $949.80 / $1,255.61 / $2,975.82	Professional		$949.80	$1,255.61	$2,975.82
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,691.87 / $3,679.42 / $9,399.59	Facility		$1,691.87	$3,679.42	$9,399.59
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,327.11 / $1,680.99 / $11,373.79	Professional		$1,327.11	$1,680.99	$11,373.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,316.65 / $1,316.65 / $1,316.65	Facility		$1,316.65	$1,316.65	$1,316.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $961.15 / $961.15 / $1,316.65	Professional		$961.15	$961.15	$1,316.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,117.93 / $1,932.17 / $5,088.75	Facility		$1,117.93	$1,932.17	$5,088.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,119.16 / $1,964.86 / $3,771.74	Professional		$1,119.16	$1,964.86	$3,771.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,333.09 / $1,481.22 / $1,629.34	Professional		$1,333.09	$1,481.22	$1,629.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,533.73 / $1,886.88 / $1,932.17	Facility		$1,533.73	$1,886.88	$1,932.17
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,534.94 / $1,932.17 / $1,932.17	Professional		$1,534.94	$1,932.17	$1,932.17
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,691.87 / $2,169.91 / $3,773.76	Facility		$1,691.87	$2,169.91	$3,773.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,839.06 / $1,886.88 / $1,886.88	Facility		$1,839.06	$1,886.88	$1,886.88
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,534.94 / $1,642.34 / $2,125.39	Professional		$1,534.94	$1,642.34	$2,125.39
United Facility/Professional Professional Modifier Low / Median / High Price $886.60 / $1,335.55 / $1,691.52	Professional		$886.60	$1,335.55	$1,691.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,085.78 / $1,171.15 / $1,171.15	Professional		$1,085.78	$1,171.15	$1,171.15