Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,552.52 / $3,524.22 / $3,679.47	Facility		$1,552.52	$3,524.22	$3,679.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,237.29 / $1,552.52 / $3,679.47	Professional		$1,237.29	$1,552.52	$3,679.47
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,091.92 / $3,972.88 / $11,410.07	Facility		$2,091.92	$3,972.88	$11,410.07
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,732.21 / $2,091.92 / $12,323.41	Professional		$1,732.21	$2,091.92	$12,323.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,366.32 / $1,366.32 / $1,366.32	Facility		$1,366.32	$1,366.32	$1,366.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $997.41 / $997.41 / $1,366.32	Professional		$997.41	$997.41	$1,366.32
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,451.52 / $2,478.77 / $6,546.57	Facility		$1,451.52	$2,478.77	$6,546.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,533.57 / $2,519.01 / $4,639.79	Professional		$1,533.57	$2,519.01	$4,639.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,648.30 / $1,831.45 / $2,014.59	Professional		$1,648.30	$1,831.45	$2,014.59
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,333.04 / $2,389.03 / $2,474.58	Facility		$2,333.04	$2,389.03	$2,474.58
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,897.88 / $1,897.88 / $1,897.88	Professional		$1,897.88	$1,897.88	$1,897.88
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,983.08 / $2,091.92 / $4,549.43	Facility		$1,983.08	$2,091.92	$4,549.43
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,983.08 / $2,160.21 / $2,683.00	Professional		$1,983.08	$2,160.21	$2,683.00
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,273.92 / $2,333.04 / $2,333.04	Facility		$2,273.92	$2,333.04	$2,333.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,897.88 / $2,030.68 / $2,627.93	Professional		$1,897.88	$2,030.68	$2,627.93
United Facility/Professional Professional Modifier Low / Median / High Price $1,090.86 / $1,643.61 / $2,081.23	Professional		$1,090.86	$1,643.61	$2,081.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,335.86 / $2,030.68 / $2,030.68	Professional		$1,335.86	$2,030.68	$2,030.68