Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,784.05 / $8,589.79 / $8,968.20	Facility		$3,784.05	$8,589.79	$8,968.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,077.09 / $3,784.05 / $8,968.20	Professional		$3,077.09	$3,784.05	$8,968.20
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $5,098.76 / $9,680.76 / $26,807.65	Facility		$5,098.76	$9,680.76	$26,807.65
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $4,076.04 / $5,142.42 / $30,647.77	Professional		$4,076.04	$5,142.42	$30,647.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,728.42 / $3,728.42 / $3,728.42	Facility		$3,728.42	$3,728.42	$3,728.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,721.75 / $2,721.75 / $3,728.42	Professional		$2,721.75	$2,721.75	$3,728.42
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $4,083.01 / $6,383.01 / $16,589.36	Facility		$4,083.01	$6,383.01	$16,589.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $4,083.01 / $6,383.01 / $11,071.88	Professional		$4,083.01	$6,383.01	$11,071.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $4,017.51 / $4,463.89 / $4,910.29	Professional		$4,017.51	$4,463.89	$4,910.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $5,686.45 / $5,822.92 / $6,154.17	Facility		$5,686.45	$5,822.92	$6,154.17
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,833.47 / $5,098.76 / $11,088.58	Facility		$4,833.47	$5,098.76	$11,088.58
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,833.47 / $5,265.23 / $6,539.42	Professional		$4,833.47	$5,265.23	$6,539.42
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,542.35 / $5,686.45 / $5,686.45	Facility		$5,542.35	$5,686.45	$5,686.45
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,625.80 / $4,949.47 / $6,405.21	Professional		$4,625.80	$4,949.47	$6,405.21
United Facility/Professional Professional Modifier Low / Median / High Price $2,562.50 / $3,856.19 / $4,888.92	Professional		$2,562.50	$3,856.19	$4,888.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3,569.66 / $3,569.66 / $3,569.66	Professional		$3,569.66	$3,569.66	$3,569.66