Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,031.44 / $4,611.37 / $4,814.51	Facility		$2,031.44	$4,611.37	$4,814.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,732.36 / $2,031.44 / $4,814.51	Professional		$1,732.36	$2,031.44	$4,814.51
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,737.23 / $5,952.82 / $14,790.81	Facility		$2,737.23	$5,952.82	$14,790.81
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,216.60 / $2,831.32 / $18,022.32	Professional		$2,216.60	$2,831.32	$18,022.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,769.18 / $1,769.18 / $1,769.18	Facility		$1,769.18	$1,769.18	$1,769.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,291.50 / $1,291.50 / $1,769.18	Professional		$1,291.50	$1,291.50	$1,769.18
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,781.32 / $3,126.00 / $8,106.56	Facility		$1,781.32	$3,126.00	$8,106.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,783.28 / $3,130.82 / $6,007.65	Professional		$1,783.28	$3,130.82	$6,007.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,156.76 / $2,396.41 / $2,636.05	Professional		$2,156.76	$2,396.41	$2,636.05
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,481.34 / $3,052.73 / $3,464.71	Facility		$2,481.34	$3,052.73	$3,464.71
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,483.33 / $3,126.00 / $3,464.71	Professional		$2,483.33	$3,126.00	$3,464.71
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,737.23 / $3,510.64 / $6,105.46	Facility		$2,737.23	$3,510.64	$6,105.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,975.37 / $3,052.73 / $3,052.73	Facility		$2,975.37	$3,052.73	$3,052.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,483.33 / $2,657.10 / $3,438.60	Professional		$2,483.33	$2,657.10	$3,438.60
United Facility/Professional Professional Modifier Low / Median / High Price $1,412.51 / $1,658.98 / $2,694.89	Professional		$1,412.51	$1,658.98	$2,694.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,014.79 / $1,014.79 / $1,806.78	Professional		$1,014.79	$1,014.79	$1,806.78