Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,911.20 / $4,338.42 / $4,529.54	Facility		$1,911.20	$4,338.42	$4,529.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,357.81 / $1,911.20 / $4,529.54	Professional		$1,357.81	$1,911.20	$4,529.54
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,575.21 / $5,600.46 / $13,256.99	Facility		$2,575.21	$5,600.46	$13,256.99
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,967.98 / $2,528.41 / $15,834.51	Professional		$1,967.98	$2,528.41	$15,834.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,119.51 / $2,119.51 / $2,119.51	Facility		$2,119.51	$2,119.51	$2,119.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,547.24 / $1,547.24 / $2,119.51	Professional		$1,547.24	$1,547.24	$2,119.51
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,666.56 / $2,999.78 / $8,058.98	Facility		$1,666.56	$2,999.78	$8,058.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,760.80 / $2,940.96 / $5,327.44	Professional		$1,760.80	$2,940.96	$5,327.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,029.11 / $2,254.57 / $2,480.02	Professional		$2,029.11	$2,254.57	$2,480.02
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,334.46 / $2,715.61 / $2,940.96	Facility		$2,334.46	$2,715.61	$2,940.96
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,646.86 / $2,940.96 / $3,235.06	Professional		$2,646.86	$2,940.96	$3,235.06
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,575.21 / $3,302.83 / $5,744.06	Facility		$2,575.21	$3,302.83	$5,744.06
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,799.25 / $2,872.03 / $2,872.03	Facility		$2,799.25	$2,872.03	$2,872.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,336.34 / $2,499.82 / $3,235.06	Professional		$2,336.34	$2,499.82	$3,235.06
United Facility/Professional Professional Modifier Low / Median / High Price $1,252.58 / $1,878.88 / $2,389.77	Professional		$1,252.58	$1,878.88	$2,389.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,526.81 / $1,526.81 / $1,526.81	Professional		$1,526.81	$1,526.81	$1,526.81