Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $984.01 / $2,233.69 / $2,332.10	Facility		$984.01	$2,233.69	$2,332.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $764.63 / $984.01 / $2,332.10	Professional		$764.63	$984.01	$2,332.10
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,478.71 / $2,883.48 / $7,017.00	Facility		$1,478.71	$2,883.48	$7,017.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,092.50 / $1,500.62 / $10,676.03	Professional		$1,092.50	$1,500.62	$10,676.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $843.35 / $843.35 / $843.35	Facility		$843.35	$843.35	$843.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $716.85 / $716.85 / $843.35	Professional		$716.85	$716.85	$843.35
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $849.03 / $1,514.20 / $3,864.37	Facility		$849.03	$1,514.20	$3,864.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $849.96 / $1,514.20 / $2,863.97	Professional		$849.96	$1,514.20	$2,863.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,284.26 / $1,461.20 / $1,607.32	Professional		$1,284.26	$1,461.20	$1,607.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,438.49 / $1,493.41 / $1,665.62	Facility		$1,438.49	$1,493.41	$1,665.62
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,202.90 / $1,202.90 / $1,202.90	Professional		$1,202.90	$1,202.90	$1,202.90
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,848.39 / $2,646.89 / $3,747.22	Facility		$1,848.39	$2,646.89	$3,747.22
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,337.24 / $1,513.30 / $2,666.29	Professional		$1,337.24	$1,513.30	$2,666.29
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,441.24 / $1,478.71 / $1,478.71	Facility		$1,441.24	$1,478.71	$1,478.71
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,105.36 / $1,665.62 / $1,665.62	Professional		$1,105.36	$1,665.62	$1,665.62
United Facility/Professional Facility Modifier Low / Median / High Price $1,799.54 / $2,159.44 / $2,159.44	Facility		$1,799.54	$2,159.44	$2,159.44
United Facility/Professional Professional Modifier Low / Median / High Price $673.33 / $1,037.58 / $1,284.61	Professional		$673.33	$1,037.58	$1,284.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,092.50 / $1,287.07 / $1,287.07	Professional		$1,092.50	$1,287.07	$1,287.07