Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,432.70 / $3,252.23 / $3,395.50	Facility		$1,432.70	$3,252.23	$3,395.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,231.44 / $1,432.70 / $3,395.50	Professional		$1,231.44	$1,432.70	$3,395.50
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $1,858.97 / $4,415.51 / $10,128.96	Facility		$1,858.97	$4,415.51	$10,128.96
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,511.83 / $1,857.88 / $10,951.02	Professional		$1,511.83	$1,857.88	$10,951.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,540.39 / $1,540.39 / $1,540.39	Facility		$1,540.39	$1,540.39	$1,540.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,124.48 / $1,124.48 / $1,540.39	Professional		$1,124.48	$1,124.48	$1,540.39
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,289.76 / $2,202.53 / $5,817.55	Facility		$1,289.76	$2,202.53	$5,817.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,362.76 / $2,238.44 / $4,123.43	Professional		$1,362.76	$2,238.44	$4,123.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,464.75 / $1,627.50 / $1,790.25	Professional		$1,464.75	$1,627.50	$1,790.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,685.19 / $2,073.23 / $2,199.00	Facility		$1,685.19	$2,073.23	$2,199.00
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,910.70 / $2,123.00 / $2,199.00	Professional		$1,910.70	$2,123.00	$2,199.00
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,858.97 / $2,384.23 / $4,146.47	Facility		$1,858.97	$2,384.23	$4,146.47
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,020.70 / $2,073.23 / $2,073.23	Facility		$2,020.70	$2,073.23	$2,073.23
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,686.53 / $1,804.55 / $2,335.30	Professional		$1,686.53	$1,804.55	$2,335.30
United Facility/Professional Professional Modifier Low / Median / High Price $896.29 / $969.40 / $1,849.48	Professional		$896.29	$969.40	$1,849.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,181.67 / $1,804.55 / $1,804.55	Professional		$1,181.67	$1,804.55	$1,804.55