Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,715.39 / $3,754.89 / $9,872.60	Facility		$1,715.39	$3,754.89	$9,872.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,075.00 / $1,715.39 / $2,737.32	Professional		$1,075.00	$1,715.39	$2,737.32
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,916.12 / $2,994.63 / $7,539.31	Facility		$1,916.12	$2,994.63	$7,539.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,655.59 / $3,565.41 / $13,686.60	Professional		$1,655.59	$3,565.41	$13,686.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,235.33 / $3,309.54 / $5,337.77	Facility		$1,235.33	$3,309.54	$5,337.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,138.82 / $2,046.19 / $2,634.12	Professional		$1,138.82	$2,046.19	$2,634.12
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,824.88 / $2,685.17 / $6,246.56	Facility		$1,824.88	$2,685.17	$6,246.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,824.88 / $3,227.40 / $5,645.22	Professional		$1,824.88	$3,227.40	$5,645.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $1,786.55 / $1,936.50	Professional		$75.00	$1,786.55	$1,936.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,824.88 / $1,824.88 / $3,832.25	Facility		$1,824.88	$1,824.88	$3,832.25
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,824.88 / $3,193.54 / $5,474.64	Facility		$1,824.88	$3,193.54	$5,474.64
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,642.39 / $2,281.10 / $2,755.57	Professional		$1,642.39	$2,281.10	$2,755.57
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,916.12 / $3,011.05 / $5,018.42	Facility		$1,916.12	$3,011.05	$5,018.42
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,127.77 / $3,551.13 / $4,243.07	Professional		$2,127.77	$3,551.13	$4,243.07
United Facility/Professional Facility Modifier Low / Median / High Price $1,376.76 / $1,824.88 / $1,824.88	Facility		$1,376.76	$1,824.88	$1,824.88
United Facility/Professional Professional Modifier Low / Median / High Price $766.45 / $1,044.06 / $2,043.87	Professional		$766.45	$1,044.06	$2,043.87