Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,461.55 / $7,857.72 / $8,203.87	Facility		$3,461.55	$7,857.72	$8,203.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,241.23 / $3,461.55 / $8,203.87	Professional		$2,241.23	$3,461.55	$8,203.87
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $4,664.21 / $10,143.54 / $23,227.17	Facility		$4,664.21	$10,143.54	$23,227.17
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $3,197.63 / $4,527.66 / $26,366.97	Professional		$3,197.63	$4,527.66	$26,366.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,523.90 / $3,523.90 / $3,523.90	Facility		$3,523.90	$3,523.90	$3,523.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,572.44 / $2,572.44 / $3,523.90	Professional		$2,572.44	$2,572.44	$3,523.90
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $2,750.02 / $5,245.58 / $12,513.75	Facility		$2,750.02	$5,245.58	$12,513.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,753.04 / $5,103.56 / $9,274.62	Professional		$2,753.04	$5,103.56	$9,274.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $3,675.11 / $4,083.46 / $4,491.80	Professional		$3,675.11	$4,083.46	$4,491.80
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $4,228.18 / $4,793.99 / $5,326.66	Facility		$4,228.18	$4,793.99	$5,326.66
Pacific Source Facility/Professional Professional Modifier Low / Median / High Price $4,482.45 / $5,326.66 / $5,326.66	Professional		$4,482.45	$5,326.66	$5,326.66
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,664.21 / $5,982.09 / $10,403.64	Facility		$4,664.21	$5,982.09	$10,403.64
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $5,070.00 / $5,201.82 / $5,201.82	Facility		$5,070.00	$5,201.82	$5,201.82
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $4,231.56 / $4,527.66 / $5,859.33	Professional		$4,231.56	$4,527.66	$5,859.33
United Facility/Professional Professional Modifier Low / Median / High Price $2,180.52 / $3,270.78 / $4,160.14	Professional		$2,180.52	$3,270.78	$4,160.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,761.05 / $1,761.05 / $2,670.21	Professional		$1,761.05	$1,761.05	$2,670.21