Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,879.47 / $6,536.40 / $6,824.34	Facility		$2,879.47	$6,536.40	$6,824.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,978.33 / $2,879.47 / $6,824.34	Professional		$1,978.33	$2,879.47	$6,824.34
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,736.20 / $8,876.27 / $18,505.52	Facility		$3,736.20	$8,876.27	$18,505.52
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,713.89 / $3,626.81 / $28,060.61	Professional		$2,713.89	$3,626.81	$28,060.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,507.59 / $2,507.59 / $2,507.59	Facility		$2,507.59	$2,507.59	$2,507.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,830.54 / $1,830.54 / $2,507.59	Professional		$1,830.54	$1,830.54	$2,507.59
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,332.19 / $4,239.75 / $11,050.26	Facility		$2,332.19	$4,239.75	$11,050.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,344.80 / $4,239.75 / $7,496.32	Professional		$2,344.80	$4,239.75	$7,496.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,943.89 / $3,270.99 / $3,598.08	Professional		$2,943.89	$3,270.99	$3,598.08
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,386.93 / $3,840.16 / $4,266.84	Facility		$3,386.93	$3,840.16	$4,266.84
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,386.93 / $3,840.16 / $4,266.84	Professional		$3,386.93	$3,840.16	$4,266.84
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,736.20 / $4,791.87 / $8,333.68	Facility		$3,736.20	$4,791.87	$8,333.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,061.25 / $4,166.84 / $4,166.84	Facility		$4,061.25	$4,166.84	$4,166.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,389.63 / $3,626.81 / $4,693.52	Professional		$3,389.63	$3,626.81	$4,693.52
United Facility/Professional Professional Modifier Low / Median / High Price $1,629.53 / $1,901.12 / $3,362.52	Professional		$1,629.53	$1,901.12	$3,362.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,639.28 / $1,639.28 / $2,151.62	Professional		$1,639.28	$1,639.28	$2,151.62