Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,762.92 / $6,271.83 / $6,548.12	Facility		$2,762.92	$6,271.83	$6,548.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,829.92 / $2,762.92 / $6,548.12	Professional		$1,829.92	$2,762.92	$6,548.12
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $3,722.85 / $8,016.27 / $17,419.57	Facility		$3,722.85	$8,016.27	$17,419.57
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $2,615.62 / $3,613.87 / $21,045.47	Professional		$2,615.62	$3,613.87	$21,045.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,694.60 / $2,694.60 / $2,694.60	Facility		$2,694.60	$2,694.60	$2,694.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,967.06 / $1,967.06 / $2,694.60	Professional		$1,967.06	$1,967.06	$2,694.60
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,060.23 / $4,039.03 / $9,375.00	Facility		$2,060.23	$4,039.03	$9,375.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,062.50 / $4,039.03 / $6,948.51	Professional		$2,062.50	$4,039.03	$6,948.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,933.38 / $3,259.32 / $3,585.25	Professional		$2,933.38	$3,259.32	$3,585.25
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $3,374.83 / $3,826.45 / $4,251.60	Facility		$3,374.83	$3,826.45	$4,251.60
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $3,659.84 / $4,251.60 / $4,676.77	Professional		$3,659.84	$4,251.60	$4,676.77
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,722.85 / $4,774.75 / $8,303.92	Facility		$3,722.85	$4,774.75	$8,303.92
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $4,046.74 / $4,151.96 / $4,151.96	Facility		$4,046.74	$4,151.96	$4,151.96
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $3,377.53 / $3,613.87 / $4,676.77	Professional		$3,377.53	$3,613.87	$4,676.77
United Facility/Professional Professional Modifier Low / Median / High Price $1,633.54 / $2,343.53 / $3,116.58	Professional		$1,633.54	$2,343.53	$3,116.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,524.79 / $1,524.79 / $2,000.39	Professional		$1,524.79	$1,524.79	$2,000.39