Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,744.42 / $4,651.21 / $15,795.00	Facility		$2,744.42	$4,651.21	$15,795.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,880.00 / $2,744.42 / $3,160.17	Professional		$1,880.00	$2,744.42	$3,160.17
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,065.58 / $4,791.06 / $13,868.10	Facility		$3,065.58	$4,791.06	$13,868.10
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,167.83 / $3,209.80 / $14,598.00	Professional		$1,167.83	$3,209.80	$14,598.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,357.97 / $3,036.38 / $7,366.08	Facility		$1,357.97	$3,036.38	$7,366.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,810.43 / $3,354.80 / $4,193.50	Professional		$1,810.43	$3,354.80	$4,193.50
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,881.14 / $3,649.50 / $8,333.92	Facility		$2,881.14	$3,649.50	$8,333.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,919.60 / $4,291.81 / $8,079.52	Professional		$2,919.60	$4,291.81	$8,079.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,919.60 / $2,919.60 / $6,131.16	Facility		$2,919.60	$2,919.60	$6,131.16
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,919.60 / $4,379.39 / $8,028.90	Facility		$2,919.60	$4,379.39	$8,028.90
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,627.64 / $3,605.71 / $4,145.83	Professional		$2,627.64	$3,605.71	$4,145.83
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,065.58 / $4,791.06 / $8,028.90	Facility		$3,065.58	$4,791.06	$8,028.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,643.09 / $5,135.42 / $7,151.28	Professional		$2,643.09	$5,135.42	$7,151.28
United Facility/Professional Professional Modifier Low / Median / High Price $1,226.23 / $1,226.23 / $3,269.95	Professional		$1,226.23	$1,226.23	$3,269.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,313.82 / $1,313.82 / $1,512.35	Professional		$1,313.82	$1,313.82	$1,512.35