Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23,789.46 / $23,789.46 / $55,975.20	Facility		$23,789.46	$23,789.46	$55,975.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22,390.08 / $23,789.46 / $23,789.46	Professional		$22,390.08	$23,789.46	$23,789.46
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $22,828.16 / $35,275.74 / $121,142.10	Facility		$22,828.16	$35,275.74	$121,142.10
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $22,599.99 / $23,789.46 / $125,944.20	Professional		$22,599.99	$23,789.46	$125,944.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23,789.46 / $24,228.42 / $50,000.00	Facility		$23,789.46	$24,228.42	$50,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23,789.46 / $23,789.46 / $23,789.46	Professional		$23,789.46	$23,789.46	$23,789.46
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,819.16 / $4,523.03 / $66,615.44	Facility		$2,819.16	$4,523.03	$66,615.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,416.14 / $3,823.73 / $25,197.56	Professional		$2,416.14	$3,823.73	$25,197.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $21,990.55 / $26,988.40	Professional		$75.00	$21,990.55	$26,988.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $43,611.16 / $79,999.20 / $79,999.20	Facility		$43,611.16	$79,999.20	$79,999.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $20,545.34 / $35,984.03 / $63,918.85	Facility		$20,545.34	$35,984.03	$63,918.85
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $21,550.45 / $23,789.46 / $29,386.98	Professional		$21,550.45	$23,789.46	$29,386.98
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $23,517.16 / $28,112.53 / $52,360.96	Facility		$23,517.16	$28,112.53	$52,360.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $22,599.99 / $23,789.46 / $23,789.46	Professional		$22,599.99	$23,789.46	$23,789.46
United Facility/Professional Professional Modifier Low / Median / High Price $23,323.00 / $23,323.00 / $27,987.60	Professional		$23,323.00	$23,323.00	$27,987.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23,323.00 / $23,323.00 / $23,323.00	Professional		$23,323.00	$23,323.00	$23,323.00