Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,318.64 / $2,993.31 / $5,409.60	Facility		$1,318.64	$2,993.31	$5,409.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,053.01 / $1,318.64 / $3,125.18	Professional		$1,053.01	$1,318.64	$3,125.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,981.59 / $4,220.37 / $9,683.48	Facility		$1,981.59	$4,220.37	$9,683.48
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,567.71 / $2,232.07 / $14,861.93	Professional		$1,567.71	$2,232.07	$14,861.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,650.90 / $1,650.90 / $1,650.90	Facility		$1,650.90	$1,650.90	$1,650.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,403.27 / $1,403.27 / $1,650.90	Professional		$1,403.27	$1,403.27	$1,650.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,302.93 / $2,416.71 / $5,720.72	Facility		$1,302.93	$2,416.71	$5,720.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,333.92 / $2,333.52 / $3,985.28	Professional		$1,333.92	$2,333.52	$3,985.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,721.00 / $1,958.13 / $2,153.94	Professional		$1,721.00	$1,958.13	$2,153.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,981.59 / $2,029.15 / $2,232.07	Facility		$1,981.59	$2,029.15	$2,232.07
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,495.98 / $2,495.98 / $2,495.98	Professional		$2,495.98	$2,495.98	$2,495.98
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,476.98 / $3,547.05 / $5,021.56	Facility		$2,476.98	$3,547.05	$5,021.56
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,792.00 / $1,981.59 / $3,573.03	Professional		$1,792.00	$1,981.59	$3,573.03
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,931.37 / $1,981.59 / $1,981.59	Facility		$1,931.37	$1,981.59	$1,981.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,481.28 / $2,232.07 / $2,232.07	Professional		$1,481.28	$2,232.07	$2,232.07
United Facility/Professional Facility Modifier Low / Median / High Price $22.92 / $926.78 / $1,224.69	Facility		$22.92	$926.78	$1,224.69
United Facility/Professional Professional Modifier Low / Median / High Price $926.78 / $1,544.63 / $2,211.31	Professional		$926.78	$1,544.63	$2,211.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,724.78 / $1,724.78 / $2,546.78	Professional		$1,724.78	$1,724.78	$2,546.78