Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,685.97 / $3,827.15 / $3,995.75	Facility		$1,685.97	$3,827.15	$3,995.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,425.16 / $1,685.97 / $3,995.75	Professional		$1,425.16	$1,685.97	$3,995.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,271.73 / $4,940.47 / $12,483.67	Facility		$2,271.73	$4,940.47	$12,483.67
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,816.07 / $2,257.29 / $15,210.51	Professional		$1,816.07	$2,257.29	$15,210.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,823.10 / $1,823.10 / $1,823.10	Facility		$1,823.10	$1,823.10	$1,823.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,330.86 / $1,330.86 / $1,823.10	Professional		$1,330.86	$1,330.86	$1,823.10
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,467.83 / $2,594.39 / $6,679.68	Facility		$1,467.83	$2,594.39	$6,679.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,469.44 / $2,594.39 / $4,950.10	Professional		$1,469.44	$2,594.39	$4,950.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,789.98 / $1,988.87 / $2,187.75	Professional		$1,789.98	$1,988.87	$2,187.75
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,059.36 / $2,533.58 / $2,850.32	Facility		$2,059.36	$2,533.58	$2,850.32
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,334.94 / $2,594.39 / $2,850.32	Professional		$2,334.94	$2,594.39	$2,850.32
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,271.73 / $2,913.62 / $5,067.16	Facility		$2,271.73	$2,913.62	$5,067.16
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,469.38 / $2,533.58 / $2,533.58	Facility		$2,469.38	$2,533.58	$2,533.58
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,061.01 / $2,205.23 / $2,853.83	Professional		$2,061.01	$2,205.23	$2,853.83
United Facility/Professional Professional Modifier Low / Median / High Price $1,111.91 / $1,753.09 / $2,220.37	Professional		$1,111.91	$1,753.09	$2,220.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $936.73 / $936.73 / $1,425.16	Professional		$936.73	$936.73	$1,425.16