Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,090.37 / $4,745.14 / $4,954.18	Facility		$2,090.37	$4,745.14	$4,954.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,700.11 / $2,090.37 / $4,954.18	Professional		$1,700.11	$2,090.37	$4,954.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,712.32 / $6,537.62 / $15,138.02	Facility		$2,712.32	$6,537.62	$15,138.02
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,237.98 / $2,964.76 / $18,962.96	Professional		$2,237.98	$2,964.76	$18,962.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,815.81 / $1,815.81 / $1,815.81	Facility		$1,815.81	$1,815.81	$1,815.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,325.54 / $1,325.54 / $1,815.81	Professional		$1,325.54	$1,325.54	$1,815.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,918.28 / $3,159.50 / $8,320.31	Facility		$1,918.28	$3,159.50	$8,320.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,928.64 / $3,213.19 / $6,165.70	Professional		$1,928.64	$3,213.19	$6,165.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,137.13 / $2,374.59 / $2,612.04	Professional		$2,137.13	$2,374.59	$2,612.04
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,458.75 / $3,024.95 / $3,097.55	Facility		$2,458.75	$3,024.95	$3,097.55
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,458.75 / $3,035.91 / $3,097.55	Professional		$2,458.75	$3,035.91	$3,097.55
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,712.32 / $3,478.69 / $6,049.90	Facility		$2,712.32	$3,478.69	$6,049.90
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,948.29 / $3,024.95 / $3,024.95	Facility		$2,948.29	$3,024.95	$3,024.95
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,460.71 / $2,632.92 / $3,407.31	Professional		$2,460.71	$2,632.92	$3,407.31
United Facility/Professional Professional Modifier Low / Median / High Price $1,340.41 / $1,563.81 / $2,765.93	Professional		$1,340.41	$1,563.81	$2,765.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,665.30 / $1,665.30 / $1,718.05	Professional		$1,665.30	$1,665.30	$1,718.05