Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,484.01 / $5,638.70 / $5,887.10	Facility		$2,484.01	$5,638.70	$5,887.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,905.69 / $2,484.01 / $5,887.10	Professional		$1,905.69	$2,484.01	$5,887.10
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,347.05 / $7,279.02 / $17,719.04	Facility		$3,347.05	$7,279.02	$17,719.04
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,636.58 / $3,325.51 / $18,980.66	Professional		$2,636.58	$3,325.51	$18,980.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,677.88 / $2,677.88 / $2,677.88	Facility		$2,677.88	$2,677.88	$2,677.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,954.85 / $1,954.85 / $2,677.88	Professional		$1,954.85	$1,954.85	$2,677.88
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,132.13 / $3,822.42 / $9,703.12	Facility		$2,132.13	$3,822.42	$9,703.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,134.46 / $3,822.42 / $7,190.97	Professional		$2,134.46	$3,822.42	$7,190.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,637.27 / $2,930.30 / $3,223.33	Professional		$2,637.27	$2,930.30	$3,223.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,034.15 / $3,732.83 / $3,822.42	Facility		$3,034.15	$3,732.83	$3,822.42
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,440.18 / $3,811.38 / $3,822.42	Professional		$3,440.18	$3,811.38	$3,822.42
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,347.05 / $4,292.75 / $7,465.66	Facility		$3,347.05	$4,292.75	$7,465.66
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,638.24 / $3,732.83 / $3,732.83	Facility		$3,638.24	$3,732.83	$3,732.83
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,036.58 / $3,249.06 / $4,204.66	Professional		$3,036.58	$3,249.06	$4,204.66
United Facility/Professional Professional Modifier Low / Median / High Price $1,690.72 / $2,546.83 / $3,225.68	Professional		$1,690.72	$2,546.83	$3,225.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,060.88 / $2,060.88 / $2,060.88	Professional		$2,060.88	$2,060.88	$2,060.88