Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,880.02 / $8,807.65 / $9,195.65	Facility		$3,880.02	$8,807.65	$9,195.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,570.62 / $3,880.02 / $9,195.65	Professional		$2,570.62	$3,880.02	$9,195.65
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,228.07 / $11,369.81 / $24,492.50	Facility		$5,228.07	$11,369.81	$24,492.50
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,606.47 / $5,075.02 / $30,123.14	Professional		$3,606.47	$5,075.02	$30,123.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,670.30 / $3,670.30 / $3,670.30	Facility		$3,670.30	$3,670.30	$3,670.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,679.32 / $2,679.32 / $3,670.30	Professional		$2,679.32	$2,679.32	$3,670.30
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,884.24 / $5,672.08 / $13,125.93	Facility		$2,884.24	$5,672.08	$13,125.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,887.41 / $5,672.08 / $9,728.09	Professional		$2,887.41	$5,672.08	$9,728.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $4,119.39 / $4,577.10 / $5,034.82	Professional		$4,119.39	$4,577.10	$5,034.82
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,739.33 / $5,373.55 / $5,970.61	Facility		$4,739.33	$5,373.55	$5,970.61
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,743.12 / $5,373.55 / $5,970.61	Professional		$4,743.12	$5,373.55	$5,970.61
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,228.07 / $6,705.27 / $11,661.34	Facility		$5,228.07	$6,705.27	$11,661.34
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,682.91 / $5,830.67 / $5,830.67	Facility		$5,682.91	$5,830.67	$5,830.67
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,743.12 / $5,075.02 / $6,567.67	Professional		$4,743.12	$5,075.02	$6,567.67
United Facility/Professional Professional Modifier Low / Median / High Price $2,287.12 / $3,430.68 / $4,363.53	Professional		$2,287.12	$3,430.68	$4,363.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,185.69 / $2,185.69 / $2,800.76	Professional		$2,185.69	$2,185.69	$2,800.76