Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,437.97 / $10,074.20 / $10,518.00	Facility		$4,437.97	$10,074.20	$10,518.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,668.42 / $4,437.97 / $10,518.00	Professional		$2,668.42	$4,437.97	$10,518.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,979.89 / $12,838.84 / $28,628.31	Facility		$5,979.89	$12,838.84	$28,628.31
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,109.51 / $5,804.82 / $40,587.48	Professional		$4,109.51	$5,804.82	$40,587.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,072.36 / $4,072.36 / $4,072.36	Facility		$4,072.36	$4,072.36	$4,072.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,972.82 / $2,972.82 / $4,072.36	Professional		$2,972.82	$2,972.82	$4,072.36
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $3,357.90 / $6,487.74 / $15,280.31	Facility		$3,357.90	$6,487.74	$15,280.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,361.59 / $6,487.74 / $11,325.16	Professional		$3,361.59	$6,487.74	$11,325.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $4,711.78 / $5,235.32 / $5,758.85	Professional		$4,711.78	$5,235.32	$5,758.85
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,211.75 / $6,146.28 / $6,829.20	Facility		$5,211.75	$6,146.28	$6,829.20
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $5,336.83 / $6,829.20 / $6,829.20	Professional		$5,336.83	$6,829.20	$6,829.20
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,979.89 / $7,669.51 / $13,338.28	Facility		$5,979.89	$7,669.51	$13,338.28
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $6,500.14 / $6,669.14 / $6,669.14	Facility		$6,500.14	$6,669.14	$6,669.14
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $5,425.20 / $5,804.82 / $7,512.12	Professional		$5,425.20	$5,804.82	$7,512.12
United Facility/Professional Professional Modifier Low / Median / High Price $2,662.49 / $4,010.66 / $5,079.68	Professional		$2,662.49	$4,010.66	$5,079.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,477.13 / $2,477.13 / $3,205.32	Professional		$2,477.13	$2,477.13	$3,205.32