Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,848.70 / $4,196.55 / $4,381.42	Facility		$1,848.70	$4,196.55	$4,381.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,492.57 / $1,848.70 / $4,381.42	Professional		$1,492.57	$1,848.70	$4,381.42
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,398.73 / $5,216.68 / $12,090.55	Facility		$2,398.73	$5,216.68	$12,090.55
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,775.69 / $2,344.39 / $16,368.35	Professional		$1,775.69	$2,344.39	$16,368.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,499.97 / $1,499.97 / $1,499.97	Facility		$1,499.97	$1,499.97	$1,499.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,094.98 / $1,094.98 / $1,546.51	Professional		$1,094.98	$1,094.98	$1,546.51
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,439.16 / $2,739.43 / $6,548.43	Facility		$1,439.16	$2,739.43	$6,548.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,440.74 / $2,634.60 / $4,853.28	Professional		$1,440.74	$2,634.60	$4,853.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,890.05 / $2,100.06 / $2,310.06	Professional		$1,890.05	$2,100.06	$2,310.06
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,174.48 / $2,665.30 / $2,739.43	Facility		$2,174.48	$2,665.30	$2,739.43
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,465.48 / $2,739.43 / $2,739.43	Professional		$2,465.48	$2,739.43	$2,739.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,398.73 / $3,076.50 / $5,350.44	Facility		$2,398.73	$3,076.50	$5,350.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,607.42 / $2,675.22 / $2,675.22	Facility		$2,607.42	$2,675.22	$2,675.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,176.23 / $2,328.52 / $3,013.37	Professional		$2,176.23	$2,328.52	$3,013.37
United Facility/Professional Professional Modifier Low / Median / High Price $1,055.02 / $1,142.94 / $2,177.02	Professional		$1,055.02	$1,142.94	$2,177.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,005.42 / $1,005.42 / $1,339.39	Professional		$1,005.42	$1,005.42	$1,339.39