Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $6,181.20 / $6,181.20 / $14,544.00	Facility		$6,181.20	$6,181.20	$14,544.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5,817.60 / $6,181.20 / $6,181.20	Professional		$5,817.60	$6,181.20	$6,181.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,943.00 / $6,181.20 / $26,506.30	Facility		$3,943.00	$6,181.20	$26,506.30
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $5,817.60 / $6,181.20 / $29,977.92	Professional		$5,817.60	$6,181.20	$29,977.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,301.26 / $5,301.26 / $12,855.56	Facility		$5,301.26	$5,301.26	$12,855.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $6,181.20 / $6,181.20 / $6,181.20	Professional		$6,181.20	$6,181.20	$6,181.20
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $956.76 / $2,110.63 / $10,746.91	Facility		$956.76	$2,110.63	$10,746.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $843.82 / $1,732.03 / $5,513.31	Professional		$843.82	$1,732.03	$5,513.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $5,151.96 / $5,620.32	Professional		$70.00	$5,151.96	$5,620.32
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $9,432.78 / $79,999.20 / $79,999.20	Facility		$9,432.78	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,548.70 / $6,032.79 / $11,040.40	Facility		$3,548.70	$6,032.79	$11,040.40
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,129.56 / $5,662.50 / $6,994.85	Professional		$5,129.56	$5,662.50	$6,994.85
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,943.00 / $4,928.75 / $8,779.09	Facility		$3,943.00	$4,928.75	$8,779.09
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $5,872.14 / $6,181.20 / $6,181.20	Professional		$5,872.14	$6,181.20	$6,181.20
United Facility/Professional Professional Modifier Low / Median / High Price $6,060.00 / $6,060.00 / $7,272.00	Professional		$6,060.00	$6,060.00	$7,272.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $5,551.47 / $5,551.47 / $5,551.47	Professional		$5,551.47	$5,551.47	$5,551.47