Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,725.74 / $3,917.43 / $4,090.00	Facility		$1,725.74	$3,917.43	$4,090.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,219.03 / $1,725.74 / $4,090.00	Professional		$1,219.03	$1,725.74	$4,090.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,325.33 / $5,020.89 / $11,580.89	Facility		$2,325.33	$5,020.89	$11,580.89
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,716.33 / $2,310.36 / $13,894.08	Professional		$1,716.33	$2,310.36	$13,894.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,599.98 / $1,599.98 / $1,599.98	Facility		$1,599.98	$1,599.98	$1,599.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,167.99 / $1,167.99 / $1,599.98	Professional		$1,167.99	$1,167.99	$1,599.98
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,366.82 / $2,606.87 / $6,220.31	Facility		$1,366.82	$2,606.87	$6,220.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,368.32 / $2,544.36 / $4,610.00	Professional		$1,368.32	$2,544.36	$4,610.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,832.21 / $2,035.79 / $2,239.36	Professional		$1,832.21	$2,035.79	$2,239.36
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,107.94 / $2,438.06 / $2,655.59	Facility		$2,107.94	$2,438.06	$2,655.59
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,390.03 / $2,655.59 / $2,681.87	Professional		$2,390.03	$2,655.59	$2,681.87
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,325.33 / $2,982.35 / $5,186.70	Facility		$2,325.33	$2,982.35	$5,186.70
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,527.63 / $2,593.35 / $2,593.35	Facility		$2,527.63	$2,593.35	$2,593.35
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,109.63 / $2,257.25 / $2,921.15	Professional		$2,109.63	$2,257.25	$2,921.15
United Facility/Professional Professional Modifier Low / Median / High Price $1,083.78 / $1,632.56 / $2,067.71	Professional		$1,083.78	$1,632.56	$2,067.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $941.93 / $941.93 / $1,317.91	Professional		$941.93	$941.93	$1,317.91