Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,251.53 / $5,110.97 / $5,336.13	Facility		$2,251.53	$5,110.97	$5,336.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,736.89 / $2,251.53 / $5,336.13	Professional		$1,736.89	$2,251.53	$5,336.13
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,033.80 / $6,678.97 / $16,090.64	Facility		$3,033.80	$6,678.97	$16,090.64
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,327.63 / $3,014.27 / $17,470.80	Professional		$2,327.63	$3,014.27	$17,470.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,571.77 / $2,571.77 / $2,571.77	Facility		$2,571.77	$2,571.77	$2,571.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,877.39 / $1,877.39 / $2,571.77	Professional		$1,877.39	$1,877.39	$2,571.77
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,931.93 / $3,464.68 / $8,791.87	Facility		$1,931.93	$3,464.68	$8,791.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,934.05 / $3,464.68 / $6,516.56	Professional		$1,934.05	$3,464.68	$6,516.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,390.44 / $2,656.05 / $2,921.65	Professional		$2,390.44	$2,656.05	$2,921.65
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,750.18 / $3,383.48 / $3,473.78	Facility		$2,750.18	$3,383.48	$3,473.78
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,752.38 / $3,464.68 / $3,473.78	Professional		$2,752.38	$3,464.68	$3,473.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,033.80 / $3,891.00 / $6,766.96	Facility		$3,033.80	$3,891.00	$6,766.96
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,297.74 / $3,383.48 / $3,383.48	Facility		$3,297.74	$3,383.48	$3,383.48
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,752.38 / $2,944.98 / $3,811.15	Professional		$2,752.38	$2,944.98	$3,811.15
United Facility/Professional Professional Modifier Low / Median / High Price $1,532.03 / $2,298.05 / $2,922.92	Professional		$1,532.03	$2,298.05	$2,922.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $861.79 / $861.79 / $1,876.10	Professional		$861.79	$861.79	$1,876.10