Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,824.02 / $4,140.53 / $4,322.93	Facility		$1,824.02	$4,140.53	$4,322.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,214.30 / $1,824.02 / $4,322.93	Professional		$1,214.30	$1,824.02	$4,322.93
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $2,457.75 / $5,345.01 / $12,160.93	Facility		$2,457.75	$5,345.01	$12,160.93
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $1,833.01 / $2,385.79 / $14,783.95	Professional		$1,833.01	$2,385.79	$14,783.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,964.43 / $1,964.43 / $1,964.43	Facility		$1,964.43	$1,964.43	$1,964.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,434.03 / $1,434.03 / $1,964.43	Professional		$1,434.03	$1,434.03	$1,964.43
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,453.27 / $2,772.39 / $6,614.06	Facility		$1,453.27	$2,772.39	$6,614.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,454.86 / $2,689.26 / $4,902.10	Professional		$1,454.86	$2,689.26	$4,902.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,936.55 / $2,151.73 / $2,366.90	Professional		$1,936.55	$2,151.73	$2,366.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $2,227.98 / $2,526.13 / $2,806.81	Facility		$2,227.98	$2,526.13	$2,806.81
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $2,428.60 / $2,806.81 / $2,806.81	Professional		$2,428.60	$2,806.81	$2,806.81
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,457.75 / $3,152.18 / $5,482.06	Facility		$2,457.75	$3,152.18	$5,482.06
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,671.57 / $2,741.03 / $2,741.03	Facility		$2,671.57	$2,741.03	$2,741.03
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $2,229.77 / $2,385.79 / $3,087.49	Professional		$2,229.77	$2,385.79	$3,087.49
United Facility/Professional Professional Modifier Low / Median / High Price $1,152.43 / $1,728.65 / $2,198.69	Professional		$1,152.43	$1,728.65	$2,198.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,083.48 / $1,083.48 / $1,396.06	Professional		$1,083.48	$1,083.48	$1,396.06