Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,179.28 / $4,946.97 / $5,164.89	Facility		$2,179.28	$4,946.97	$5,164.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,394.78 / $2,179.28 / $5,164.89	Professional		$1,394.78	$2,179.28	$5,164.89
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,936.44 / $6,549.80 / $14,630.94	Facility		$2,936.44	$6,549.80	$14,630.94
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,181.66 / $2,850.48 / $16,888.66	Professional		$2,181.66	$2,850.48	$16,888.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,743.07 / $1,743.07 / $1,743.07	Facility		$1,743.07	$1,743.07	$1,743.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,272.44 / $1,272.44 / $2,084.86	Professional		$1,272.44	$1,272.44	$2,084.86
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,754.93 / $3,347.98 / $7,986.56	Facility		$1,754.93	$3,347.98	$7,986.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,756.86 / $3,213.56 / $5,919.10	Professional		$1,756.86	$3,213.56	$5,919.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,313.74 / $2,570.83 / $2,827.91	Professional		$2,313.74	$2,570.83	$2,827.91
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,661.94 / $3,018.15 / $3,353.50	Facility		$2,661.94	$3,018.15	$3,353.50
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,789.55 / $3,353.50 / $3,353.50	Professional		$2,789.55	$3,353.50	$3,353.50
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,936.44 / $3,766.13 / $6,549.80	Facility		$2,936.44	$3,766.13	$6,549.80
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,191.91 / $3,274.90 / $3,274.90	Facility		$3,191.91	$3,274.90	$3,274.90
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,664.07 / $2,850.48 / $3,688.85	Professional		$2,664.07	$2,850.48	$3,688.85
United Facility/Professional Professional Modifier Low / Median / High Price $1,391.68 / $2,087.51 / $2,655.13	Professional		$1,391.68	$2,087.51	$2,655.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,477.95 / $1,477.95 / $1,696.36	Professional		$1,477.95	$1,477.95	$1,696.36