Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,097.58 / $2,491.53 / $2,601.29	Facility		$1,097.58	$2,491.53	$2,601.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $926.79 / $1,097.58 / $2,601.29	Professional		$926.79	$1,097.58	$2,601.29
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,478.94 / $3,107.99 / $7,783.07	Facility		$1,478.94	$3,107.99	$7,783.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,203.08 / $1,507.43 / $9,825.29	Professional		$1,203.08	$1,507.43	$9,825.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $908.63 / $908.63 / $908.63	Facility		$908.63	$908.63	$908.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $663.30 / $663.30 / $908.63	Professional		$663.30	$663.30	$908.63
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $965.28 / $1,722.78 / $4,628.27	Facility		$965.28	$1,722.78	$4,628.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,019.90 / $1,689.00 / $3,085.74	Professional		$1,019.90	$1,689.00	$3,085.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,165.32 / $1,294.80 / $1,424.28	Professional		$1,165.32	$1,294.80	$1,424.28
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,520.10 / $1,689.00 / $1,853.57	Facility		$1,520.10	$1,689.00	$1,853.57
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,341.76 / $1,341.76 / $1,341.76	Professional		$1,341.76	$1,341.76	$1,341.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,402.00 / $1,478.94 / $3,216.35	Facility		$1,402.00	$1,478.94	$3,216.35
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,402.00 / $1,527.23 / $2,183.40	Professional		$1,402.00	$1,527.23	$2,183.40
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,607.61 / $1,649.41 / $1,649.41	Facility		$1,607.61	$1,649.41	$1,649.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,341.76 / $1,435.65 / $1,857.90	Professional		$1,341.76	$1,435.65	$1,857.90
United Facility/Professional Facility Modifier Low / Median / High Price $1,938.85 / $2,326.62 / $2,326.62	Facility		$1,938.85	$2,326.62	$2,326.62
United Facility/Professional Professional Modifier Low / Median / High Price $725.45 / $1,088.18 / $1,384.07	Professional		$725.45	$1,088.18	$1,384.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $967.28 / $967.28 / $1,435.65	Professional		$967.28	$967.28	$1,435.65