Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,178.67 / $4,945.58 / $5,163.45	Facility		$2,178.67	$4,945.58	$5,163.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,936.59 / $2,178.67 / $5,163.45	Professional		$1,936.59	$2,178.67	$5,163.45
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,826.89 / $8,135.65 / $17,217.72	Facility		$2,826.89	$8,135.65	$17,217.72
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,332.51 / $2,881.34 / $25,718.94	Professional		$2,332.51	$2,881.34	$25,718.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,017.28 / $2,017.28 / $2,017.28	Facility		$2,017.28	$2,017.28	$2,017.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,472.61 / $1,472.61 / $2,342.82	Professional		$1,472.61	$1,472.61	$2,342.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,031.12 / $3,432.81 / $8,846.61	Facility		$2,031.12	$3,432.81	$8,846.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,033.35 / $3,458.73 / $6,850.87	Professional		$2,033.35	$3,458.73	$6,850.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,227.41 / $2,474.91 / $2,722.40	Professional		$2,227.41	$2,474.91	$2,722.40
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,562.63 / $3,152.72 / $4,304.52	Facility		$2,562.63	$3,152.72	$4,304.52
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,905.55 / $3,228.39 / $4,304.52	Professional		$2,905.55	$3,228.39	$4,304.52
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,826.89 / $3,625.63 / $6,305.44	Facility		$2,826.89	$3,625.63	$6,305.44
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,072.83 / $3,152.72 / $3,152.72	Facility		$3,072.83	$3,152.72	$3,152.72
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,564.67 / $2,744.13 / $3,551.23	Professional		$2,564.67	$2,744.13	$3,551.23
United Facility/Professional Professional Modifier Low / Median / High Price $1,489.14 / $1,613.24 / $3,072.83	Professional		$1,489.14	$1,613.24	$3,072.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,087.41 / $2,087.41 / $2,744.13	Professional		$2,087.41	$2,087.41	$2,744.13