Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,351.06 / $4,477.00 / $5,572.01	Facility		$2,351.06	$4,477.00	$5,572.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,657.56 / $2,351.06 / $5,572.01	Professional		$1,657.56	$2,351.06	$5,572.01
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,167.90 / $6,536.12 / $14,301.99	Facility		$3,167.90	$6,536.12	$14,301.99
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,135.77 / $3,147.51 / $17,908.25	Professional		$2,135.77	$3,147.51	$17,908.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,711.28 / $1,711.28 / $1,711.28	Facility		$1,711.28	$1,711.28	$1,711.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,249.23 / $1,249.23 / $1,711.28	Professional		$1,249.23	$1,249.23	$1,711.28
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,723.08 / $3,436.94 / $7,842.18	Facility		$1,723.08	$3,436.94	$7,842.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,724.97 / $3,436.94 / $5,811.53	Professional		$1,724.97	$3,436.94	$5,811.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,496.11 / $2,773.46 / $3,050.80	Professional		$2,496.11	$2,773.46	$3,050.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,871.75 / $3,315.12 / $3,617.83	Facility		$2,871.75	$3,315.12	$3,617.83
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,256.05 / $3,617.83 / $3,617.83	Professional		$3,256.05	$3,617.83	$3,617.83
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,167.90 / $4,063.00 / $7,066.08	Facility		$3,167.90	$4,063.00	$7,066.08
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,443.51 / $3,533.04 / $3,533.04	Facility		$3,443.51	$3,533.04	$3,533.04
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,874.05 / $3,075.16 / $3,979.61	Professional		$2,874.05	$3,075.16	$3,979.61
United Facility/Professional Professional Modifier Low / Median / High Price $1,366.29 / $2,058.57 / $2,606.69	Professional		$1,366.29	$2,058.57	$2,606.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,454.19 / $1,454.19 / $1,660.84	Professional		$1,454.19	$1,454.19	$1,660.84