Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14,230.80 / $32,303.90 / $33,727.00	Facility		$14,230.80	$32,303.90	$33,727.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11,341.15 / $14,230.80 / $33,727.00	Professional		$11,341.15	$14,230.80	$33,727.00
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $19,175.09 / $41,701.24 / $104,478.94	Facility		$19,175.09	$41,701.24	$104,478.94
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $15,594.39 / $19,163.82 / $112,957.80	Professional		$15,594.39	$19,163.82	$112,957.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $14,513.81 / $14,513.81 / $14,513.81	Facility		$14,513.81	$14,513.81	$14,513.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10,595.08 / $10,595.08 / $14,513.81	Professional		$10,595.08	$10,595.08	$14,513.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $12,729.41 / $23,197.08 / $57,386.25	Facility		$12,729.41	$23,197.08	$57,386.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $13,303.20 / $23,088.14 / $42,531.01	Professional		$13,303.20	$23,088.14	$42,531.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $18,573.09 / $21,132.05 / $23,245.25	Professional		$18,573.09	$21,132.05	$23,245.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $19,708.65 / $21,898.50 / $22,682.29	Facility		$19,708.65	$21,898.50	$22,682.29
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $17,396.43 / $17,396.43 / $17,396.43	Professional		$17,396.43	$17,396.43	$17,396.43
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $19,175.09 / $24,593.04 / $42,770.50	Facility		$19,175.09	$24,593.04	$42,770.50
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $20,843.32 / $21,385.25 / $21,385.25	Facility		$20,843.32	$21,385.25	$21,385.25
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $17,396.43 / $18,613.73 / $24,088.35	Professional		$17,396.43	$18,613.73	$24,088.35
United Facility/Professional Professional Modifier Low / Median / High Price $9,999.21 / $14,631.97 / $19,077.20	Professional		$9,999.21	$14,631.97	$19,077.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $12,489.26 / $12,489.26 / $12,489.26	Professional		$12,489.26	$12,489.26	$12,489.26