Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,196.28 / $2,715.56 / $2,835.18	Facility		$1,196.28	$2,715.56	$2,835.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $953.37 / $1,196.28 / $2,835.18	Professional		$953.37	$1,196.28	$2,835.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,611.91 / $3,061.26 / $8,782.71	Facility		$1,611.91	$3,061.26	$8,782.71
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,325.42 / $1,625.71 / $9,495.57	Professional		$1,325.42	$1,625.71	$9,495.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,329.56 / $1,329.56 / $1,329.56	Facility		$1,329.56	$1,329.56	$1,329.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $970.58 / $970.58 / $1,329.56	Professional		$970.58	$970.58	$1,329.56
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,118.40 / $1,909.90 / $5,044.37	Facility		$1,118.40	$1,909.90	$5,044.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,181.41 / $1,940.56 / $3,574.80	Professional		$1,181.41	$1,940.56	$3,574.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,270.08 / $1,411.21 / $1,552.33	Professional		$1,270.08	$1,411.21	$1,552.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,748.82 / $1,840.86 / $1,906.74	Facility		$1,748.82	$1,840.86	$1,906.74
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,462.39 / $1,462.39 / $1,462.39	Professional		$1,462.39	$1,462.39	$1,462.39
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,528.05 / $1,611.91 / $3,505.53	Facility		$1,528.05	$1,611.91	$3,505.53
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,528.05 / $1,664.54 / $2,067.37	Professional		$1,528.05	$1,664.54	$2,067.37
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,752.15 / $1,797.71 / $1,797.71	Facility		$1,752.15	$1,797.71	$1,797.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,462.39 / $1,564.73 / $2,024.95	Professional		$1,462.39	$1,564.73	$2,024.95
United Facility/Professional Professional Modifier Low / Median / High Price $840.55 / $1,266.17 / $1,603.66	Professional		$840.55	$1,266.17	$1,603.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,029.32 / $1,564.73 / $1,564.73	Professional		$1,029.32	$1,564.73	$1,564.73