Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,054.32 / $1,054.32 / $1,054.32	Facility		$1,054.32	$1,054.32	$1,054.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $896.22 / $1,054.32 / $1,130.71	Professional		$896.22	$1,054.32	$1,130.71
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,130.71 / $2,459.03 / $5,682.97	Facility		$1,130.71	$2,459.03	$5,682.97
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,071.88 / $1,261.04 / $7,994.61	Professional		$1,071.88	$1,261.04	$7,994.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $517.14 / $517.14 / $517.14	Professional		$517.14	$517.14	$517.14
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $856.53 / $1,408.78 / $3,538.46	Facility		$856.53	$1,408.78	$3,538.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $856.53 / $1,364.28 / $2,313.42	Professional		$856.53	$1,364.28	$2,313.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $890.92 / $989.92 / $1,088.91	Professional		$890.92	$989.92	$1,088.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,113.25 / $1,261.04 / $1,291.30	Facility		$1,113.25	$1,261.04	$1,291.30
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,071.88 / $1,130.71 / $2,459.03	Facility		$1,071.88	$1,130.71	$2,459.03
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,071.88 / $1,167.63 / $1,776.58	Professional		$1,071.88	$1,167.63	$1,776.58
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,229.08 / $1,261.04 / $1,261.04	Facility		$1,229.08	$1,261.04	$1,261.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,031.75 / $1,097.60 / $1,420.43	Professional		$1,031.75	$1,097.60	$1,420.43
United Facility/Professional Professional Modifier Low / Median / High Price $496.96 / $538.37 / $1,025.47	Professional		$496.96	$538.37	$1,025.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $608.87 / $608.87 / $1,097.60	Professional		$608.87	$608.87	$1,097.60