Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,544.96 / $3,237.05 / $5,076.66	Facility		$2,544.96	$3,237.05	$5,076.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $2,502.79 / $3,237.05	Professional		$2,429.89	$2,502.79	$3,237.05
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,324.34 / $3,523.26 / $12,207.45	Facility		$2,324.34	$3,523.26	$12,207.45
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $2,521.58 / $10,655.19	Professional		$2,429.89	$2,521.58	$10,655.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,292.35 / $2,292.35 / $5,852.40	Facility		$2,292.35	$2,292.35	$5,852.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $2,429.89 / $2,980.06	Professional		$2,429.89	$2,429.89	$2,980.06
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,207.16 / $2,704.47 / $6,621.20	Facility		$2,207.16	$2,704.47	$6,621.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,195.42 / $2,634.09 / $5,196.84	Professional		$2,195.42	$2,634.09	$5,196.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $2,672.87 / $3,280.35	Professional		$75.00	$2,672.87	$3,280.35
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,429.89 / $3,037.36 / $5,054.17	Facility		$2,429.89	$3,037.36	$5,054.17
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,091.91 / $3,591.87 / $6,508.16	Facility		$2,091.91	$3,591.87	$6,508.16
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,549.96 / $2,663.80 / $4,667.34	Professional		$2,549.96	$2,663.80	$4,667.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,348.84 / $2,818.61 / $4,697.68	Facility		$2,348.84	$2,818.61	$4,697.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,308.40 / $2,429.89 / $2,527.09	Professional		$2,308.40	$2,429.89	$2,527.09
United Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $2,429.89 / $2,915.87	Professional		$2,429.89	$2,429.89	$2,915.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,413.36 / $2,413.36 / $2,413.36	Professional		$2,413.36	$2,413.36	$2,413.36