Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,662.27 / $3,773.35 / $3,939.58	Facility		$1,662.27	$3,773.35	$3,939.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,324.74 / $1,662.27 / $3,939.58	Professional		$1,324.74	$1,662.27	$3,939.58
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,239.81 / $11,409.47 / $11,409.47	Facility		$2,239.81	$11,409.47	$11,409.47
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,847.00 / $2,813.71 / $19,080.45	Professional		$1,847.00	$2,813.71	$19,080.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,482.94 / $1,482.94 / $1,482.94	Facility		$1,482.94	$1,482.94	$1,482.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,260.50 / $1,260.50 / $1,482.94	Professional		$1,260.50	$1,260.50	$1,482.94
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,345.62 / $2,553.60 / $4,726.52	Facility		$1,345.62	$2,553.60	$4,726.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,494.95 / $2,609.08 / $5,035.33	Professional		$1,494.95	$2,609.08	$5,035.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $2,557.92 / $2,557.92	Professional		$60.00	$2,557.92	$2,557.92
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,302.13 / $2,557.92 / $2,813.71	Facility		$2,302.13	$2,557.92	$2,813.71
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,032.05 / $2,032.05 / $2,032.05	Professional		$2,032.05	$2,032.05	$2,032.05
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,239.81 / $2,239.81 / $4,141.63	Facility		$2,239.81	$2,239.81	$4,141.63
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,867.28 / $2,813.71 / $2,813.71	Professional		$1,867.28	$2,813.71	$2,813.71
United Facility/Professional Professional Modifier Low / Median / High Price $1,183.99 / $1,783.51 / $2,258.89	Professional		$1,183.99	$1,783.51	$2,258.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,425.38 / $2,174.23 / $2,174.23	Professional		$1,425.38	$2,174.23	$2,174.23