Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,075.71 / $6,981.86 / $7,289.43	Facility		$3,075.71	$6,981.86	$7,289.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,287.02 / $3,075.71 / $7,289.43	Professional		$2,287.02	$3,075.71	$7,289.43
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,144.32 / $9,012.92 / $22,146.98	Facility		$4,144.32	$9,012.92	$22,146.98
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,201.83 / $4,169.58 / $27,149.58	Professional		$3,201.83	$4,169.58	$27,149.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,006.81 / $3,006.81 / $3,006.81	Facility		$3,006.81	$3,006.81	$3,006.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,194.96 / $2,194.96 / $3,006.81	Professional		$2,194.96	$2,194.96	$3,006.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,623.53 / $4,732.93 / $11,938.12	Facility		$2,623.53	$4,732.93	$11,938.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,626.41 / $4,732.93 / $8,847.62	Professional		$2,626.41	$4,732.93	$8,847.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,265.47 / $3,628.31 / $3,991.14	Professional		$3,265.47	$3,628.31	$3,991.14
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,756.90 / $4,574.04 / $4,732.93	Facility		$3,756.90	$4,574.04	$4,732.93
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,259.64 / $4,732.93 / $4,732.93	Professional		$4,259.64	$4,732.93	$4,732.93
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,144.32 / $5,315.31 / $9,244.02	Facility		$4,144.32	$5,315.31	$9,244.02
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,504.88 / $4,622.01 / $4,622.01	Facility		$4,504.88	$4,622.01	$4,622.01
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,759.91 / $4,023.00 / $5,206.22	Professional		$3,759.91	$4,023.00	$5,206.22
United Facility/Professional Professional Modifier Low / Median / High Price $2,080.16 / $3,133.47 / $3,968.67	Professional		$2,080.16	$3,133.47	$3,968.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,845.36 / $1,845.36 / $2,547.31	Professional		$1,845.36	$1,845.36	$2,547.31