Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,843.74 / $6,455.29 / $6,739.66	Facility		$2,843.74	$6,455.29	$6,739.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,266.31 / $2,843.74 / $6,739.66	Professional		$2,266.31	$2,843.74	$6,739.66
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,831.76 / $8,333.15 / $20,912.72	Facility		$3,831.76	$8,333.15	$20,912.72
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,116.21 / $3,829.50 / $22,572.40	Professional		$3,116.21	$3,829.50	$22,572.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,502.67 / $2,502.67 / $2,502.67	Facility		$2,502.67	$2,502.67	$2,502.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,826.95 / $1,826.95 / $2,502.67	Professional		$1,826.95	$1,826.95	$2,502.67
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,519.79 / $4,375.97 / $11,467.50	Facility		$2,519.79	$4,375.97	$11,467.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,522.55 / $4,428.72 / $8,498.42	Professional		$2,522.55	$4,428.72	$8,498.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,019.19 / $3,354.66 / $3,690.12	Professional		$3,019.19	$3,354.66	$3,690.12
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,473.56 / $4,273.41 / $4,532.60	Facility		$3,473.56	$4,273.41	$4,532.60
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,938.37 / $4,375.97 / $4,532.60	Professional		$3,938.37	$4,375.97	$4,532.60
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,831.76 / $4,914.42 / $8,546.82	Facility		$3,831.76	$4,914.42	$8,546.82
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,165.12 / $4,273.41 / $4,273.41	Facility		$4,165.12	$4,273.41	$4,273.41
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,476.33 / $3,719.57 / $4,813.57	Professional		$3,476.33	$3,719.57	$4,813.57
United Facility/Professional Professional Modifier Low / Median / High Price $1,998.13 / $2,997.20 / $3,812.18	Professional		$1,998.13	$2,997.20	$3,812.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,360.60 / $2,360.60 / $2,693.73	Professional		$2,360.60	$2,360.60	$2,693.73