Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,971.11 / $4,474.42 / $4,671.53	Facility		$1,971.11	$4,474.42	$4,671.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,842.45 / $1,971.11 / $4,671.53	Professional		$1,842.45	$1,971.11	$4,671.53
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,655.94 / $5,946.23 / $15,617.77	Facility		$2,655.94	$5,946.23	$15,617.77
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,214.21 / $2,885.30 / $18,465.93	Professional		$2,214.21	$2,885.30	$18,465.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,289.62 / $2,289.62 / $2,289.62	Facility		$2,289.62	$2,289.62	$2,289.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,671.42 / $1,671.42 / $2,289.62	Professional		$1,671.42	$1,671.42	$2,289.62
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,815.45 / $3,090.83 / $8,261.25	Facility		$1,815.45	$3,090.83	$8,261.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,817.44 / $3,093.82 / $6,122.67	Professional		$1,817.44	$3,093.82	$6,122.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,092.71 / $2,325.23 / $2,557.76	Professional		$2,092.71	$2,325.23	$2,557.76
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,407.66 / $2,962.07 / $3,684.89	Facility		$2,407.66	$2,962.07	$3,684.89
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,729.84 / $3,033.16 / $3,684.89	Professional		$2,729.84	$3,033.16	$3,684.89
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,655.94 / $3,406.38 / $5,924.14	Facility		$2,655.94	$3,406.38	$5,924.14
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,887.01 / $2,962.07 / $2,962.07	Facility		$2,887.01	$2,962.07	$2,962.07
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,409.58 / $2,578.19 / $3,336.48	Professional		$2,409.58	$2,578.19	$3,336.48
United Facility/Professional Professional Modifier Low / Median / High Price $1,439.45 / $2,159.17 / $2,746.27	Professional		$1,439.45	$2,159.17	$2,746.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,145.93 / $1,145.93 / $1,748.40	Professional		$1,145.93	$1,145.93	$1,748.40