Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,116.92 / $6,470.00 / $22,024.00	Facility		$2,116.92	$6,470.00	$22,024.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,082.80 / $2,116.92 / $3,890.07	Professional		$1,082.80	$2,116.92	$3,890.07
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,898.38 / $10,956.90 / $24,231.69	Facility		$1,898.38	$10,956.90	$24,231.69
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,931.10 / $3,287.44 / $11,852.93	Professional		$1,931.10	$3,287.44	$11,852.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,031.00 / $1,031.00 / $3,759.09	Facility		$1,031.00	$1,031.00	$3,759.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,278.83 / $2,166.03 / $4,364.79	Professional		$1,278.83	$2,166.03	$4,364.79
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,513.16 / $1,917.74 / $3,592.06	Facility		$1,513.16	$1,917.74	$3,592.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,513.16 / $1,929.74 / $3,592.06	Professional		$1,513.16	$1,929.74	$3,592.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $157.62 / $780.98 / $2,674.30	Professional		$157.62	$780.98	$2,674.30
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,740.48 / $2,414.01 / $2,783.18	Facility		$1,740.48	$2,414.01	$2,783.18
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,504.82 / $1,865.00 / $1,898.38	Facility		$1,504.82	$1,865.00	$1,898.38
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,955.58 / $3,145.88 / $3,773.94	Professional		$1,955.58	$3,145.88	$3,773.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $7,995.08 / $10,950.64 / $20,959.32	Facility		$7,995.08	$10,950.64	$20,959.32
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,902.05 / $2,702.10 / $3,561.21	Professional		$1,902.05	$2,702.10	$3,561.21
United Facility/Professional Facility Modifier Low / Median / High Price $1,620.00 / $2,155.00 / $11,941.00	Facility		$1,620.00	$2,155.00	$11,941.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,500.79 / $2,089.77 / $3,778.10	Professional		$1,500.79	$2,089.77	$3,778.10