Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,570.20 / $1,570.20 / $1,570.20	Facility		$1,570.20	$1,570.20	$1,570.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,427.45 / $1,494.10 / $1,570.20	Professional		$1,427.45	$1,494.10	$1,570.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,427.45 / $2,065.40 / $6,525.00	Facility		$1,427.45	$2,065.40	$6,525.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,427.45 / $1,427.45 / $6,960.00	Professional		$1,427.45	$1,427.45	$6,960.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,346.65 / $1,346.65 / $2,774.18	Facility		$1,346.65	$1,346.65	$2,774.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,427.45 / $1,427.45 / $1,750.65	Professional		$1,427.45	$1,427.45	$1,750.65
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,427.45 / $1,427.45 / $1,927.06	Facility		$1,427.45	$1,427.45	$1,927.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,427.45 / $1,427.45 / $1,784.31	Professional		$1,427.45	$1,427.45	$1,784.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $60.00 / $60.00	Professional		$30.00	$60.00	$60.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,370.73 / $1,427.45 / $2,844.91	Facility		$1,370.73	$1,427.45	$2,844.91
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,444.20 / $1,444.20 / $1,542.17	Facility		$1,444.20	$1,444.20	$1,542.17
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,542.17 / $1,583.47 / $2,682.26	Professional		$1,542.17	$1,583.47	$2,682.26
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,427.45 / $1,427.45 / $1,427.45	Facility		$1,427.45	$1,427.45	$1,427.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,356.08 / $1,427.45 / $1,427.45	Professional		$1,356.08	$1,427.45	$1,427.45
United Facility/Professional Professional Modifier Low / Median / High Price $1,427.45 / $1,427.45 / $1,712.94	Professional		$1,427.45	$1,427.45	$1,712.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,427.45 / $1,427.45 / $1,459.55	Professional		$1,427.45	$1,427.45	$1,459.55