Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,177.21 / $7,212.27 / $7,529.99	Facility		$3,177.21	$7,212.27	$7,529.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,982.49 / $3,177.21 / $7,529.99	Professional		$1,982.49	$3,177.21	$7,529.99
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,281.09 / $8,908.15 / $20,802.65	Facility		$4,281.09	$8,908.15	$20,802.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,161.42 / $4,155.75 / $24,201.14	Professional		$3,161.42	$4,155.75	$24,201.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,728.17 / $2,728.17 / $2,728.17	Facility		$2,728.17	$2,728.17	$2,728.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,991.56 / $1,991.56 / $2,777.70	Professional		$1,991.56	$1,991.56	$2,777.70
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,494.76 / $4,758.58 / $11,353.12	Facility		$2,494.76	$4,758.58	$11,353.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,497.50 / $4,678.09 / $8,413.19	Professional		$2,497.50	$4,678.09	$8,413.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,373.24 / $3,748.05 / $4,122.85	Professional		$3,373.24	$3,748.05	$4,122.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,872.04 / $4,361.47 / $4,889.12	Facility		$3,872.04	$4,361.47	$4,889.12
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,964.97 / $4,889.12 / $4,889.12	Professional		$3,964.97	$4,889.12	$4,889.12
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,281.09 / $5,490.71 / $9,549.06	Facility		$4,281.09	$5,490.71	$9,549.06
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,653.54 / $4,774.53 / $4,774.53	Facility		$4,653.54	$4,774.53	$4,774.53
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,883.99 / $4,155.75 / $5,378.03	Professional		$3,883.99	$4,155.75	$5,378.03
United Facility/Professional Professional Modifier Low / Median / High Price $1,978.08 / $2,967.12 / $3,773.92	Professional		$1,978.08	$2,967.12	$3,773.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,838.07 / $1,838.07 / $2,396.26	Professional		$1,838.07	$1,838.07	$2,396.26