Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,180.26 / $7,219.19 / $7,537.22	Facility		$3,180.26	$7,219.19	$7,537.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,334.25 / $3,180.26 / $7,537.22	Professional		$2,334.25	$3,180.26	$7,537.22
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,285.20 / $9,319.28 / $22,345.83	Facility		$4,285.20	$9,319.28	$22,345.83
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,282.90 / $4,257.62 / $26,975.23	Professional		$3,282.90	$4,257.62	$26,975.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,249.00 / $3,249.00 / $3,249.00	Facility		$3,249.00	$3,249.00	$3,249.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,371.77 / $2,371.77 / $3,249.00	Professional		$2,371.77	$2,371.77	$3,249.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,651.74 / $4,893.82 / $12,068.43	Facility		$2,651.74	$4,893.82	$12,068.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,654.65 / $4,855.22 / $8,943.62	Professional		$2,654.65	$4,855.22	$8,943.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,376.46 / $3,751.63 / $4,126.79	Professional		$3,376.46	$3,751.63	$4,126.79
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,884.60 / $4,668.49 / $4,893.82	Facility		$3,884.60	$4,668.49	$4,893.82
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,404.43 / $4,893.82 / $4,991.70	Professional		$4,404.43	$4,893.82	$4,991.70
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,285.20 / $5,495.99 / $9,558.24	Facility		$4,285.20	$5,495.99	$9,558.24
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,658.01 / $4,779.12 / $4,779.12	Facility		$4,658.01	$4,779.12	$4,779.12
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,887.70 / $4,159.75 / $5,383.20	Professional		$3,887.70	$4,159.75	$5,383.20
United Facility/Professional Professional Modifier Low / Median / High Price $2,102.75 / $3,154.13 / $4,011.78	Professional		$2,102.75	$3,154.13	$4,011.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,081.62 / $2,081.62 / $2,574.31	Professional		$2,081.62	$2,081.62	$2,574.31