Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,251.98 / $7,381.99 / $7,707.19	Facility		$3,251.98	$7,381.99	$7,707.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,800.75 / $3,251.98 / $7,707.19	Professional		$2,800.75	$3,251.98	$7,707.19
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,219.54 / $10,022.50 / $22,996.26	Facility		$4,219.54	$10,022.50	$22,996.26
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,432.47 / $4,217.06 / $24,906.67	Professional		$3,432.47	$4,217.06	$24,906.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,756.64 / $2,756.64 / $2,756.64	Facility		$2,756.64	$2,756.64	$2,756.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,012.35 / $2,012.35 / $3,125.18	Professional		$2,012.35	$2,012.35	$3,125.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,928.00 / $5,000.17 / $13,204.86	Facility		$2,928.00	$5,000.17	$13,204.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,094.11 / $5,082.32 / $9,361.50	Professional		$3,094.11	$5,082.32	$9,361.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,324.74 / $3,694.16 / $4,063.57	Professional		$3,324.74	$3,694.16	$4,063.57
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,825.09 / $4,705.89 / $5,001.34	Facility		$3,825.09	$4,705.89	$5,001.34
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,336.95 / $4,818.83 / $5,001.34	Professional		$4,336.95	$4,818.83	$5,001.34
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,219.54 / $5,411.77 / $9,411.78	Facility		$4,219.54	$5,411.77	$9,411.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,586.64 / $4,705.89 / $4,705.89	Facility		$4,586.64	$4,705.89	$4,705.89
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,828.15 / $4,096.01 / $5,300.71	Professional		$3,828.15	$4,096.01	$5,300.71
United Facility/Professional Professional Modifier Low / Median / High Price $2,034.92 / $2,200.91 / $4,199.05	Professional		$2,034.92	$2,200.91	$4,199.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,828.47 / $2,828.47 / $2,828.47	Professional		$2,828.47	$2,828.47	$2,828.47