Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,769.86 / $3,035.46 / $5,611.94	Facility		$2,769.86	$3,035.46	$5,611.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,752.01 / $3,372.57	Professional		$2,698.05	$2,752.01	$3,372.57
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,580.15 / $3,928.28 / $13,290.65	Facility		$2,580.15	$3,928.28	$13,290.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,967.86 / $11,735.90	Professional		$2,698.05	$2,967.86	$11,735.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,545.33 / $2,658.13 / $5,316.26	Facility		$2,545.33	$2,658.13	$5,316.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $3,308.93	Professional		$2,698.05	$2,698.05	$3,308.93
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $8,060.19	Facility		$2,698.05	$2,698.05	$8,060.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $6,295.73	Professional		$2,698.05	$2,698.05	$6,295.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $2,923.94 / $3,588.47	Professional		$70.00	$2,923.94	$3,588.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,698.05 / $3,105.31 / $8,094.15	Facility		$2,698.05	$3,105.31	$8,094.15
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,322.13 / $3,964.20 / $7,224.41	Facility		$2,322.13	$3,964.20	$7,224.41
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,808.59 / $3,385.35 / $6,118.71	Professional		$2,808.59	$3,385.35	$6,118.71
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,618.85 / $3,142.62 / $5,498.59	Facility		$2,618.85	$3,142.62	$5,498.59
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,967.86 / $3,237.66	Professional		$2,698.05	$2,967.86	$3,237.66
United Facility/Professional Professional Modifier Low / Median / High Price $2,698.05 / $2,698.05 / $3,237.66	Professional		$2,698.05	$2,698.05	$3,237.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,658.13 / $2,698.05 / $2,698.05	Professional		$2,658.13	$2,698.05	$2,698.05