Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $947.83 / $2,151.57 / $2,246.36	Facility		$947.83	$2,151.57	$2,246.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $755.38 / $947.83 / $2,246.36	Professional		$755.38	$947.83	$2,246.36
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,277.14 / $2,425.48 / $6,958.79	Facility		$1,277.14	$2,425.48	$6,958.79
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,064.72 / $1,288.08 / $7,523.58	Professional		$1,064.72	$1,288.08	$7,523.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $967.10 / $967.10 / $967.10	Facility		$967.10	$967.10	$967.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $705.98 / $705.98 / $967.10	Professional		$705.98	$705.98	$967.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $886.08 / $1,513.16 / $3,996.75	Facility		$886.08	$1,513.16	$3,996.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $936.20 / $1,537.78 / $2,832.53	Professional		$936.20	$1,537.78	$2,832.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,006.30 / $1,118.11 / $1,229.93	Professional		$1,006.30	$1,118.11	$1,229.93
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,424.34 / $1,458.52 / $1,604.37	Facility		$1,424.34	$1,458.52	$1,604.37
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,158.67 / $1,158.67 / $1,158.67	Professional		$1,158.67	$1,158.67	$1,158.67
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,210.69 / $1,277.14 / $2,777.46	Facility		$1,210.69	$1,277.14	$2,777.46
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,210.69 / $1,318.84 / $1,637.99	Professional		$1,210.69	$1,318.84	$1,637.99
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,388.25 / $1,424.34 / $1,424.34	Facility		$1,388.25	$1,424.34	$1,424.34
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,158.67 / $1,239.74 / $1,604.37	Professional		$1,158.67	$1,239.74	$1,604.37
United Facility/Professional Professional Modifier Low / Median / High Price $666.00 / $1,003.23 / $1,270.64	Professional		$666.00	$1,003.23	$1,270.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $811.81 / $1,239.74 / $1,239.74	Professional		$811.81	$1,239.74	$1,239.74