Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,528.53 / $5,739.76 / $5,992.62	Facility		$2,528.53	$5,739.76	$5,992.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,698.49 / $2,528.53 / $5,992.62	Professional		$1,698.49	$2,528.53	$5,992.62
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,407.03 / $7,409.47 / $16,803.40	Facility		$3,407.03	$7,409.47	$16,803.40
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,383.31 / $3,307.28 / $19,260.05	Professional		$2,383.31	$3,307.28	$19,260.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,476.09 / $2,476.09 / $2,476.09	Facility		$2,476.09	$2,476.09	$2,476.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,807.55 / $1,807.55 / $2,476.09	Professional		$1,807.55	$1,807.55	$2,476.09
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,999.27 / $3,813.76 / $9,098.43	Facility		$1,999.27	$3,813.76	$9,098.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,001.46 / $3,727.96 / $6,743.29	Professional		$2,001.46	$3,727.96	$6,743.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,684.52 / $2,982.81 / $3,281.09	Professional		$2,684.52	$2,982.81	$3,281.09
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,088.53 / $3,501.83 / $3,890.92	Facility		$3,088.53	$3,501.83	$3,890.92
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,088.53 / $3,890.92 / $3,890.92	Professional		$3,088.53	$3,890.92	$3,890.92
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,407.03 / $4,369.68 / $7,599.46	Facility		$3,407.03	$4,369.68	$7,599.46
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,703.44 / $3,799.73 / $3,799.73	Facility		$3,703.44	$3,799.73	$3,799.73
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,090.99 / $3,307.28 / $4,280.01	Professional		$3,090.99	$3,307.28	$4,280.01
United Facility/Professional Professional Modifier Low / Median / High Price $1,585.34 / $2,378.01 / $3,024.62	Professional		$1,585.34	$2,378.01	$3,024.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,328.07 / $1,328.07 / $1,932.42	Professional		$1,328.07	$1,328.07	$1,932.42