Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,983.90 / $4,500.00 / $20,680.40	Facility		$1,983.90	$4,500.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,416.26 / $1,983.90 / $4,142.35	Professional		$1,416.26	$1,983.90	$4,142.35
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,186.63 / $18,877.79 / $36,111.08	Facility		$2,186.63	$18,877.79	$36,111.08
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,326.13 / $4,054.11 / $14,991.83	Professional		$2,326.13	$4,054.11	$14,991.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,392.67 / $4,392.67 / $7,318.13	Facility		$4,392.67	$4,392.67	$7,318.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,022.78 / $3,307.19 / $4,867.71	Professional		$2,022.78	$3,307.19	$4,867.71
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,990.38 / $3,469.86 / $9,370.75	Facility		$1,990.38	$3,469.86	$9,370.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,001.24 / $3,296.36 / $4,930.63	Professional		$2,001.24	$3,296.36	$4,930.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $278.70 / $1,809.09 / $3,683.53	Professional		$278.70	$1,809.09	$3,683.53
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,319.30 / $3,084.47 / $3,313.15	Facility		$2,319.30	$3,084.47	$3,313.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,186.63 / $2,259.87 / $2,568.11	Facility		$2,186.63	$2,259.87	$2,568.11
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,326.13 / $3,755.75 / $4,634.95	Professional		$2,326.13	$3,755.75	$4,634.95
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $12,241.40 / $18,867.00 / $36,111.08	Facility		$12,241.40	$18,867.00	$36,111.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,230.07 / $3,250.84 / $4,378.80	Professional		$2,230.07	$3,250.84	$4,378.80
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $3,509.00 / $17,644.00	Facility		$2,912.00	$3,509.00	$17,644.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,967.28 / $2,824.32 / $4,731.91	Professional		$1,967.28	$2,824.32	$4,731.91