Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,116.52 / $2,534.50 / $2,646.15	Facility		$1,116.52	$2,534.50	$2,646.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,044.95 / $1,116.52 / $2,646.15	Professional		$1,044.95	$1,116.52	$2,646.15
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,504.44 / $3,438.96 / $8,608.62	Facility		$1,504.44	$3,438.96	$8,608.62
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,254.23 / $1,494.76 / $10,968.65	Professional		$1,254.23	$1,494.76	$10,968.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,324.18 / $1,324.18 / $1,324.18	Facility		$1,324.18	$1,324.18	$1,324.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $966.65 / $966.65 / $1,324.18	Professional		$966.65	$966.65	$1,324.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,039.22 / $1,769.44 / $4,708.06	Facility		$1,039.22	$1,769.44	$4,708.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,040.35 / $1,769.44 / $3,505.29	Professional		$1,040.35	$1,769.44	$3,505.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,185.40 / $1,317.12 / $1,448.83	Professional		$1,185.40	$1,317.12	$1,448.83
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,363.80 / $1,677.85 / $2,202.54	Facility		$1,363.80	$1,677.85	$2,202.54
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,546.31 / $1,718.12 / $2,202.54	Professional		$1,546.31	$1,718.12	$2,202.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,504.44 / $1,929.53 / $3,355.70	Facility		$1,504.44	$1,929.53	$3,355.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,635.33 / $1,677.85 / $1,677.85	Facility		$1,635.33	$1,677.85	$1,677.85
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,364.89 / $1,460.40 / $1,889.93	Professional		$1,364.89	$1,460.40	$1,889.93
United Facility/Professional Facility Modifier Low / Median / High Price $640.00 / $640.00 / $640.00	Facility		$640.00	$640.00	$640.00
United Facility/Professional Professional Modifier Low / Median / High Price $824.12 / $1,236.18 / $1,572.31	Professional		$824.12	$1,236.18	$1,572.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $964.55 / $964.55 / $1,460.40	Professional		$964.55	$964.55	$1,460.40