Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,920.51 / $4,359.56 / $4,551.60	Facility		$1,920.51	$4,359.56	$4,551.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,138.75 / $1,920.51 / $4,551.60	Professional		$1,138.75	$1,920.51	$4,551.60
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,587.76 / $5,359.97 / $12,123.54	Facility		$2,587.76	$5,359.97	$12,123.54
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,774.73 / $2,512.01 / $16,944.43	Professional		$1,774.73	$2,512.01	$16,944.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,654.54 / $1,654.54 / $1,654.54	Facility		$1,654.54	$1,654.54	$1,654.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,207.81 / $1,207.81 / $1,654.54	Professional		$1,207.81	$1,207.81	$1,654.54
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,432.79 / $2,807.54 / $6,521.25	Facility		$1,432.79	$2,807.54	$6,521.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,434.36 / $2,807.54 / $4,832.60	Professional		$1,434.36	$2,807.54	$4,832.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,039.00 / $2,265.56 / $2,492.11	Professional		$2,039.00	$2,265.56	$2,492.11
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,224.12 / $2,886.04 / $2,955.30	Facility		$2,224.12	$2,886.04	$2,955.30
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,347.73 / $2,347.73 / $2,347.73	Professional		$2,347.73	$2,347.73	$2,347.73
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,587.76 / $3,318.95 / $5,772.08	Facility		$2,587.76	$3,318.95	$5,772.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,812.90 / $2,886.04 / $2,886.04	Facility		$2,812.90	$2,886.04	$2,886.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,347.73 / $2,512.01 / $3,250.83	Professional		$2,347.73	$2,512.01	$3,250.83
United Facility/Professional Professional Modifier Low / Median / High Price $1,136.22 / $1,630.05 / $2,167.76	Professional		$1,136.22	$1,630.05	$2,167.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $843.06 / $843.06 / $1,376.42	Professional		$843.06	$843.06	$1,376.42