Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,520.99 / $7,992.65 / $8,344.75	Facility		$3,520.99	$7,992.65	$8,344.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,416.39 / $3,520.99 / $8,344.75	Professional		$2,416.39	$3,520.99	$8,344.75
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,744.31 / $14,269.36 / $25,854.57	Facility		$4,744.31	$14,269.36	$25,854.57
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,699.56 / $4,713.77 / $45,109.85	Professional		$3,699.56	$4,713.77	$45,109.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,578.08 / $3,578.08 / $3,578.08	Facility		$3,578.08	$3,578.08	$3,578.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,612.00 / $2,612.00 / $3,578.08	Professional		$2,612.00	$2,612.00	$3,578.08
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,040.76 / $5,418.13 / $13,836.56	Facility		$3,040.76	$5,418.13	$13,836.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,044.10 / $5,418.13 / $10,255.20	Professional		$3,044.10	$5,418.13	$10,255.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,738.23 / $4,153.59 / $4,568.94	Professional		$3,738.23	$4,153.59	$4,568.94
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,300.80 / $4,876.32 / $5,418.13	Facility		$4,300.80	$4,876.32	$5,418.13
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,832.77 / $5,418.13 / $5,418.13	Professional		$4,832.77	$5,418.13	$5,418.13
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,744.31 / $6,084.81 / $10,582.28	Facility		$4,744.31	$6,084.81	$10,582.28
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,157.06 / $5,291.14 / $5,291.14	Facility		$5,157.06	$5,291.14	$5,291.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,304.24 / $4,605.41 / $5,959.94	Professional		$4,304.24	$4,605.41	$5,959.94
United Facility/Professional Professional Modifier Low / Median / High Price $2,411.02 / $3,631.86 / $4,599.89	Professional		$2,411.02	$3,631.86	$4,599.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,227.33 / $2,227.33 / $2,952.48	Professional		$2,227.33	$2,227.33	$2,952.48