Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,848.01 / $6,464.98 / $6,749.78	Facility		$2,848.01	$6,464.98	$6,749.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,702.92 / $2,848.01 / $6,749.78	Professional		$1,702.92	$2,848.01	$6,749.78
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,837.52 / $7,917.70 / $17,077.79	Facility		$3,837.52	$7,917.70	$17,077.79
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,549.19 / $3,725.18 / $21,693.67	Professional		$2,549.19	$3,725.18	$21,693.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,400.00 / $2,400.00 / $2,400.00	Facility		$2,400.00	$2,400.00	$2,400.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,752.00 / $1,752.00 / $2,400.00	Professional		$1,752.00	$1,752.00	$2,400.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,067.96 / $4,163.43 / $9,411.56	Facility		$2,067.96	$4,163.43	$9,411.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,070.23 / $4,163.43 / $6,974.99	Professional		$2,070.23	$4,163.43	$6,974.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,023.73 / $3,359.71 / $3,695.68	Professional		$3,023.73	$3,359.71	$3,695.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,326.01 / $3,814.39 / $4,382.56	Facility		$3,326.01	$3,814.39	$4,382.56
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,405.83 / $4,382.56 / $4,382.56	Professional		$3,405.83	$4,382.56	$4,382.56
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,837.52 / $4,921.82 / $8,559.68	Facility		$3,837.52	$4,921.82	$8,559.68
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,171.39 / $4,279.84 / $4,279.84	Facility		$4,171.39	$4,279.84	$4,279.84
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,481.56 / $3,725.18 / $4,820.82	Professional		$3,481.56	$3,725.18	$4,820.82
United Facility/Professional Professional Modifier Low / Median / High Price $1,639.81 / $2,459.71 / $3,128.54	Professional		$1,639.81	$2,459.71	$3,128.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,826.02 / $1,826.02 / $2,055.03	Professional		$1,826.02	$1,826.02	$2,055.03