Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.00 / $5,128.00 / $20,680.40	Facility		$1,733.00	$5,128.00	$20,680.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,067.85 / $1,543.17 / $3,092.13	Professional		$1,067.85	$1,543.17	$3,092.13
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $9,866.94 / $16,595.73 / $31,745.76	Facility		$9,866.94	$16,595.73	$31,745.76
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,656.75 / $2,903.34 / $10,049.48	Professional		$1,656.75	$2,903.34	$10,049.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,147.74 / $4,147.74 / $6,910.09	Facility		$4,147.74	$4,147.74	$6,910.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,420.06 / $2,438.46 / $3,559.28	Professional		$1,420.06	$2,438.46	$3,559.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,467.48 / $2,588.30 / $11,234.92	Facility		$1,467.48	$2,588.30	$11,234.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,512.31 / $2,436.08 / $4,655.70	Professional		$1,512.31	$2,436.08	$4,655.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $74.23 / $364.68 / $2,518.70	Professional		$74.23	$364.68	$2,518.70
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,709.12 / $2,217.03 / $2,356.19	Facility		$1,709.12	$2,217.03	$2,356.19
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,569.65 / $1,596.76 / $2,513.62	Facility		$1,569.65	$1,596.76	$2,513.62
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,684.95 / $2,663.48 / $3,274.93	Professional		$1,684.95	$2,663.48	$3,274.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $10,761.59 / $16,586.25 / $31,745.76	Facility		$10,761.59	$16,586.25	$31,745.76
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,600.83 / $2,296.96 / $3,093.94	Professional		$1,600.83	$2,296.96	$3,093.94
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 $1,457.56 / $2,526.59 / $3,323.88	Professional		$1,457.56	$2,526.59	$3,323.88