Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,116.62 / $20,680.40	Facility		$1,733.00	$5,116.62	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,077.93 / $1,389.11 / $2,753.31	Professional		$1,077.93	$1,389.11	$2,753.31
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,968.10 / $9,879.37 / $25,560.89	Facility		$5,968.10	$9,879.37	$25,560.89
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,483.17 / $2,588.77 / $8,980.58	Professional		$1,483.17	$2,588.77	$8,980.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,353.44 / $2,353.44 / $3,920.80	Facility		$2,353.44	$2,353.44	$3,920.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,315.88 / $2,162.82 / $3,180.96	Professional		$1,315.88	$2,162.82	$3,180.96
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,295.26 / $2,411.29 / $5,967.13	Facility		$1,295.26	$2,411.29	$5,967.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,301.58 / $2,335.69 / $3,144.37	Professional		$1,301.58	$2,335.69	$3,144.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $150.54 / $1,227.77 / $2,391.45	Professional		$150.54	$1,227.77	$2,391.45
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,563.10 / $2,043.50 / $2,112.51	Facility		$1,563.10	$2,043.50	$2,112.51
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,401.58 / $1,440.92 / $1,470.05	Facility		$1,401.58	$1,440.92	$1,470.05
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,483.17 / $2,403.53 / $2,955.31	Professional		$1,483.17	$2,403.53	$2,955.31
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,406.33 / $9,873.73 / $18,898.13	Facility		$6,406.33	$9,873.73	$18,898.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,429.43 / $2,065.09 / $2,791.98	Professional		$1,429.43	$2,065.09	$2,791.98
United Facility/Professional Facility Modifier Low / Median / High Price $1,550.00 / $2,431.00 / $11,261.00	Facility		$1,550.00	$2,431.00	$11,261.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,344.21 / $2,110.01 / $3,011.39	Professional		$1,344.21	$2,110.01	$3,011.39