Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,202.62 / $4,999.95 / $5,220.21	Facility		$2,202.62	$4,999.95	$5,220.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,905.72 / $2,202.62 / $5,220.21	Professional		$1,905.72	$2,202.62	$5,220.21
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,967.88 / $6,778.82 / $17,754.05	Facility		$2,967.88	$6,778.82	$17,754.05
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,474.27 / $3,361.97 / $21,074.59	Professional		$2,474.27	$3,361.97	$21,074.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,117.90 / $2,117.90 / $2,117.90	Facility		$2,117.90	$2,117.90	$2,117.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,546.07 / $1,546.07 / $2,251.75	Professional		$1,546.07	$1,546.07	$2,251.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,132.58 / $3,604.30 / $9,287.83	Facility		$2,132.58	$3,604.30	$9,287.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,134.92 / $3,630.87 / $7,191.80	Professional		$2,134.92	$3,630.87	$7,191.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,338.50 / $2,598.34 / $2,858.17	Professional		$2,338.50	$2,598.34	$2,858.17
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,050.47 / $3,389.41 / $3,811.44	Facility		$3,050.47	$3,389.41	$3,811.44
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,692.58 / $2,692.58 / $2,692.58	Professional		$2,692.58	$2,692.58	$2,692.58
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,967.88 / $3,806.47 / $6,619.94	Facility		$2,967.88	$3,806.47	$6,619.94
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,226.09 / $3,309.97 / $3,309.97	Facility		$3,226.09	$3,309.97	$3,309.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,692.58 / $2,881.00 / $3,728.35	Professional		$2,692.58	$2,881.00	$3,728.35
United Facility/Professional Professional Modifier Low / Median / High Price $1,690.94 / $2,547.16 / $3,226.09	Professional		$1,690.94	$2,547.16	$3,226.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,142.81 / $1,142.81 / $2,063.67	Professional		$1,142.81	$1,142.81	$2,063.67