Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,692.20 / $6,111.29 / $6,380.51	Facility		$2,692.20	$6,111.29	$6,380.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,697.57 / $2,692.20 / $6,380.51	Professional		$1,697.57	$2,692.20	$6,380.51
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,627.56 / $7,781.90 / $16,444.91	Facility		$3,627.56	$7,781.90	$16,444.91
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,437.79 / $3,521.36 / $22,490.28	Professional		$2,437.79	$3,521.36	$22,490.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,479.82 / $2,479.82 / $2,479.82	Facility		$2,479.82	$2,479.82	$2,479.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,810.27 / $1,810.27 / $2,479.82	Professional		$1,810.27	$1,810.27	$2,479.82
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $1,954.68 / $3,935.64 / $8,895.93	Facility		$1,954.68	$3,935.64	$8,895.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,956.82 / $3,935.64 / $6,592.69	Professional		$1,956.82	$3,935.64	$6,592.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,858.30 / $3,175.89 / $3,493.47	Professional		$2,858.30	$3,175.89	$3,493.47
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,288.45 / $3,728.50 / $4,142.78	Facility		$3,288.45	$3,728.50	$4,142.78
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,288.45 / $4,142.78 / $4,142.78	Professional		$3,288.45	$4,142.78	$4,142.78
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,627.56 / $4,652.53 / $8,091.36	Facility		$3,627.56	$4,652.53	$8,091.36
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $3,943.16 / $4,045.68 / $4,045.68	Facility		$3,943.16	$4,045.68	$4,045.68
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,291.08 / $3,521.36 / $4,557.06	Professional		$3,291.08	$3,521.36	$4,557.06
United Facility/Professional Professional Modifier Low / Median / High Price $1,550.09 / $2,334.98 / $2,957.37	Professional		$1,550.09	$2,334.98	$2,957.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,321.83 / $1,321.83 / $1,898.20	Professional		$1,321.83	$1,321.83	$1,898.20