Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,514.51 / $3,437.94 / $3,589.39	Facility		$1,514.51	$3,437.94	$3,589.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $906.46 / $1,514.51 / $3,589.39	Professional		$906.46	$1,514.51	$3,589.39
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,040.71 / $4,438.04 / $9,810.68	Facility		$2,040.71	$4,438.04	$9,810.68
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,444.69 / $1,980.96 / $11,557.54	Professional		$1,444.69	$1,980.96	$11,557.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,132.82 / $1,132.82 / $1,132.82	Facility		$1,132.82	$1,132.82	$1,132.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $826.96 / $826.96 / $1,481.92	Professional		$826.96	$826.96	$1,481.92
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,140.68 / $2,214.01 / $5,190.93	Facility		$1,140.68	$2,214.01	$5,190.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,141.93 / $2,214.01 / $3,847.04	Professional		$1,141.93	$2,214.01	$3,847.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,607.94 / $1,786.61 / $1,965.27	Professional		$1,607.94	$1,786.61	$1,965.27
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,770.43 / $2,006.46 / $2,330.54	Facility		$1,770.43	$2,006.46	$2,330.54
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,812.92 / $2,097.48 / $2,330.54	Professional		$1,812.92	$2,097.48	$2,330.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,040.71 / $2,617.31 / $4,551.84	Facility		$2,040.71	$2,617.31	$4,551.84
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,218.25 / $2,275.92 / $2,275.92	Facility		$2,218.25	$2,275.92	$2,275.92
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,851.41 / $1,980.96 / $2,563.59	Professional		$1,851.41	$1,980.96	$2,563.59
United Facility/Professional Facility Modifier Low / Median / High Price $1,052.80 / $1,052.80 / $1,052.80	Facility		$1,052.80	$1,052.80	$1,052.80
United Facility/Professional Professional Modifier Low / Median / High Price $904.45 / $1,362.73 / $1,725.57	Professional		$904.45	$1,362.73	$1,725.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $565.16 / $565.16 / $1,980.96	Professional		$565.16	$565.16	$1,980.96