Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,162.43 / $7,074.40 / $25,859.80	Facility		$3,162.43	$7,074.40	$25,859.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,490.00 / $3,023.75 / $4,493.20	Professional		$2,490.00	$3,023.75	$4,493.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,019.00 / $7,843.98 / $22,705.00	Facility		$5,019.00	$7,843.98	$22,705.00
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,912.50 / $4,875.60 / $23,900.00	Professional		$1,912.50	$4,875.60	$23,900.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,060.00 / $4,971.20 / $12,059.82	Facility		$4,060.00	$4,971.20	$12,059.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,964.18 / $5,492.49 / $6,865.61	Professional		$2,964.18	$5,492.49	$6,865.61
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,717.27 / $5,975.00 / $13,645.08	Facility		$4,717.27	$5,975.00	$13,645.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,780.00 / $7,026.60 / $13,227.85	Professional		$4,780.00	$7,026.60	$13,227.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $766.84 / $1,054.41 / $4,600.00	Professional		$766.84	$1,054.41	$4,600.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,780.00 / $4,780.00 / $10,038.00	Facility		$4,780.00	$4,780.00	$10,038.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,600.00 / $7,170.00 / $13,145.00	Facility		$4,600.00	$7,170.00	$13,145.00
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,302.00 / $5,736.00 / $6,787.60	Professional		$4,302.00	$5,736.00	$6,787.60
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,019.00 / $7,843.98 / $13,145.00	Facility		$5,019.00	$7,843.98	$13,145.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,327.16 / $8,407.78 / $11,707.98	Professional		$4,327.16	$8,407.78	$11,707.98
United Facility/Professional Professional Modifier Low / Median / High Price $2,007.60 / $2,007.60 / $5,353.60	Professional		$2,007.60	$2,007.60	$5,353.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,151.00 / $2,151.00 / $2,476.04	Professional		$2,151.00	$2,151.00	$2,476.04