Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,569.75 / $3,563.33 / $3,720.31	Facility		$1,569.75	$3,563.33	$3,720.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,272.25 / $1,569.75 / $3,720.31	Professional		$1,272.25	$1,569.75	$3,720.31
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,115.14 / $4,971.05 / $11,959.60	Facility		$2,115.14	$4,971.05	$11,959.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,762.43 / $2,101.53 / $14,435.44	Professional		$1,762.43	$2,101.53	$14,435.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,800.00 / $1,800.00 / $1,800.00	Facility		$1,800.00	$1,800.00	$1,800.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,314.00 / $1,314.00 / $1,800.00	Professional		$1,314.00	$1,314.00	$1,800.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,437.80 / $2,447.86 / $6,542.81	Facility		$1,437.80	$2,447.86	$6,542.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,439.38 / $2,463.86 / $4,848.32	Professional		$1,439.38	$2,463.86	$4,848.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,666.60 / $1,851.78 / $2,036.95	Professional		$1,666.60	$1,851.78	$2,036.95
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,917.40 / $2,358.94 / $2,544.50	Facility		$1,917.40	$2,358.94	$2,544.50
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $1,918.94 / $2,415.55 / $2,657.11	Professional		$1,918.94	$2,415.55	$2,657.11
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,115.14 / $2,712.78 / $4,717.88	Facility		$2,115.14	$2,712.78	$4,717.88
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,299.16 / $2,358.94 / $2,358.94	Facility		$2,299.16	$2,358.94	$2,358.94
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $1,918.94 / $2,053.21 / $2,657.11	Professional		$1,918.94	$2,053.21	$2,657.11
United Facility/Professional Professional Modifier Low / Median / High Price $1,140.05 / $1,717.33 / $2,175.07	Professional		$1,140.05	$1,717.33	$2,175.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,428.52 / $1,428.52 / $1,711.10	Professional		$1,428.52	$1,428.52	$1,711.10