Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,096.90 / $2,489.96 / $2,599.65	Facility		$1,096.90	$2,489.96	$2,599.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $857.68 / $1,096.90 / $2,599.65	Professional		$857.68	$1,096.90	$2,599.65
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,478.00 / $3,005.96 / $8,127.52	Facility		$1,478.00	$3,005.96	$8,127.52
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,220.08 / $1,514.53 / $9,493.87	Professional		$1,220.08	$1,514.53	$9,493.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,260.83 / $1,260.83 / $1,260.83	Facility		$1,260.83	$1,260.83	$1,260.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $920.41 / $920.41 / $1,260.83	Professional		$920.41	$920.41	$1,260.83
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,024.32 / $1,749.23 / $4,625.32	Facility		$1,024.32	$1,749.23	$4,625.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,082.52 / $1,778.12 / $3,275.24	Professional		$1,082.52	$1,778.12	$3,275.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,164.57 / $1,293.97 / $1,423.36	Professional		$1,164.57	$1,293.97	$1,423.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,519.13 / $1,675.15 / $1,721.68	Facility		$1,519.13	$1,675.15	$1,721.68
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,401.11 / $1,478.00 / $3,214.30	Facility		$1,401.11	$1,478.00	$3,214.30
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,401.11 / $1,526.26 / $1,962.73	Professional		$1,401.11	$1,526.26	$1,962.73
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,606.59 / $1,648.36 / $1,648.36	Facility		$1,606.59	$1,648.36	$1,648.36
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,340.90 / $1,434.73 / $1,856.71	Professional		$1,340.90	$1,434.73	$1,856.71
United Facility/Professional Professional Modifier Low / Median / High Price $770.08 / $1,104.78 / $1,469.22	Professional		$770.08	$1,104.78	$1,469.22
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,026.79 / $1,026.79 / $1,434.73	Professional		$1,026.79	$1,026.79	$1,434.73