Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,736.08 / $3,940.90 / $4,114.51	Facility		$1,736.08	$3,940.90	$4,114.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,505.71 / $1,736.08 / $4,114.51	Professional		$1,505.71	$1,736.08	$4,114.51
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,252.62 / $5,352.48 / $12,388.80	Facility		$2,252.62	$5,352.48	$12,388.80
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,855.91 / $2,402.23 / $15,058.46	Professional		$1,855.91	$2,402.23	$15,058.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,549.06 / $1,549.06 / $1,549.06	Facility		$1,549.06	$1,549.06	$1,549.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,130.81 / $1,130.81 / $1,661.18	Professional		$1,130.81	$1,130.81	$1,661.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,553.24 / $2,602.21 / $6,735.93	Facility		$1,553.24	$2,602.21	$6,735.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,561.92 / $2,624.00 / $4,993.13	Professional		$1,561.92	$2,624.00	$4,993.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,774.91 / $1,972.13 / $2,169.34	Professional		$1,774.91	$1,972.13	$2,169.34
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,042.03 / $2,512.26 / $2,688.76	Facility		$2,042.03	$2,512.26	$2,688.76
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,043.66 / $2,572.55 / $2,688.76	Professional		$2,043.66	$2,572.55	$2,688.76
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,252.62 / $2,889.10 / $5,024.52	Facility		$2,252.62	$2,889.10	$5,024.52
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,448.60 / $2,512.26 / $2,512.26	Facility		$2,448.60	$2,512.26	$2,512.26
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,043.66 / $2,186.67 / $2,829.81	Professional		$2,043.66	$2,186.67	$2,829.81
United Facility/Professional Professional Modifier Low / Median / High Price $1,085.30 / $1,173.83 / $2,239.51	Professional		$1,085.30	$1,173.83	$2,239.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,480.00 / $1,665.30 / $1,665.30	Professional		$1,480.00	$1,665.30	$1,665.30